Richard Ruth, PhD

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by Michael Lewis; New York: Guilford Press; 2014
352 pages • $50 (hardcover)

Clinicians are busy people. It is our gift-we improve and save many lives-and our burden. So for many of us, keeping up with the ever-expanding science bases of our professions is yet another part of what makes our daily work, as Freud put it, impossible. Complicating this task further, as indeed Freud also noted, is the inherently interdisciplinary scope of clinical endeavors. We must be masters of many sciences, as well as of much that lies beyond science, and bring what we know to clinical focus.

Clinicians enticed to pick up Michael Lewis’s latest book will encounter an exciting perspective on this structural impossibility. This volume is written from an emerging edge of basic science-a developmental psychology in active conversation with neuroscience, other biological realms, evolutionary psychology, and social/contextual thinking that seeks, and will reward, a clinical readership.

Lewis starts with an observation, culled from his lifetime of fertile and multivariegated research: that we tend to talk about emotions without ever really saying what they are. With both theoretical and scientific elegance, he goes on to bring together what contemporary developmental sciences suggest we know about this and related topics (and well-framed questions about what we do not yet know and need to discover). The result is a dense, rich book that is certain to change how you understand emotional life.

For Lewis, emotions are defined as “thoughts about our evolutionary-derived action patterns that occur within and are molded by our social niche” and have an essentially developmental nature. Human infants are born with sensations and bodily action patterns that may be innate but immediately begin interacting with culturally contextualized experience in the service of adaptation with an essential evolutionary dimension. From this matrix emerge early emotions of sadness, fear, disgust, anger, happiness, and joy. In the second year of life, in typically developing children, self-awareness emerges, which Lewis calls consciousness. Consciousness leads children to connect and consider their biologically organized sensations and “action patterns-in-context,” giving rise to a second set of self-aware, or self-conscious, emotions, such as shame, guilt, embarrassment, empathy, and envy.

Lewis’s rigorous, both experimentally and observationally grounded, developmental psychology is integrative. Contemporary perspectives in the neurobiology of psychological conditions and in psychoanalysis are brought into the book’s conversation, as well as relevant contributions from an astonishing diversity of other disciplines. Lewis’s melding of nuanced developmental research findings with a sophisticated conceptual framework for considering emotional life will challenge readers grown accustomed to thinking in more rigid silos.

In a style that is simultaneously tight and meandering, after laying out foundational notions of what emotions and emotional development are, Lewis discusses a range of topics in developmental psychology-development as such, as well as aspects of mental, emotional, and behavioral life approached through a developmental lens.

Clinically engaged readers may grow impatient as Lewis explores these and related topics in the manner one might expect of a consummate researcher-at times he is Socratic, at other moments his tone is that of a sharp methodological critic. At still other points, he deconstructs what we assume we know but may not understand as intimately as we think we do. But the patient reader will find something of unusual value.

In tackling the developmental topics he frames, Lewis eschews both psychological and biological reductionism. While his is real-world research never straying too far from issues of pragmatic application, he understands intersections inductively: “What does the science say that an intervention might be crafted to fit?” is a question he often poses. This is an antidote to our more accustomed contemporary pathways of clinical thinking.

In Chapter 11, Lewis takes up more traditional topics in atypical development and psychopathology. He scaffolds his explorations with fresh perspectives based in the conceptual, developmental framework and research bases through which he has taken the reader, seeing problems from the vantage point of how atypical emotions develop through misfits between action patterns and situations.

Lewis brings his thinking to considering how problems in the development of consciousness may lead to understandings of the psychopathology of intellectual disabilities and autism spectrum disorders. He examines problems in the development of what he terms “exposed self-conscious emotions” and describes specific developmental pathways through which problems with empathy can stem from “differences of biological action patterns associated with others’ distress.” Problems in the development of the evaluative emotions of shame, guilt, and pride are potentially implicated in conduct problems, depression, and pathological rage. He makes the intriguing suggestion that violently delinquent behavior may have its roots in the conversion of shame to blame as a pathway of emotional development gone awry or, alternatively, that a child’s need to avoid intolerable levels of shame may be at the root of dissociation. Hubris, as Lewis names the self-evaluative emotion of pride gone awry, is implicated in the development of narcissism.

Clinicians will reap the most benefit from 

The Rise of Consciousness and the Development of Emotional Life

 if they resist the temptation to skip through to Chapter 11 and instead read and think through what leads up to it. This will equip them to look at clinically familiar phenomena with a fresh perspective, that of an accomplished developmental thinker-an idiom likely to be both oddly familiar and disorientingly new to many clinicians.

Articles

This volume is written from an emerging edge of basic science and will reward a clinical readership.