Britain On the Couch: Treating a Low Serotonin Society.

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James, Oliver. Britain On the Couch: Treating a Low Serotonin Society. London: Random Century, 1997. xiii + 402 pp. £16.99.This book is written by a psychologist for the lay person about why the average person was unhappier in 1997 than in 1950 in spite of being wealthier. James, a writer of books, weekly columns, and television programs for the public, argues that advanced capitalism is the culprit because it thrives on marketing idealized images that promote consumerism based on envy of the ideal. This in turn leads to low self-esteem as individuals try to keep up with exaggerated expectations in a treadmill struggle that leads to depression. At the same time social attachments are breaking down and traditional patterns of social class interaction by sex, degree of wealth, power, and status are becoming more rancorous. The friction between women and men as their roles change, the widening income gap between the wealthy and the poor, and the scandalizing of the Royal family are additional causes of what James terms the low-serotonin society. Solutions offered by James include the short-term remedies of pills and therapy. Longer-term remedies include an emphasis on communitarianism and other variants of collectivism that might mitigate the destructive effects of advanced capitalism. He also notes that more effective solutions await advances in economic theory. James' argument is supported by a wide variety of studies and he uses illustrative clinical examples. He is fair minded and informative about the options open to depressed individuals, and the average person has much to learn from this book.The professional would find little unfamiliar in James' recipe. I had the fantasy that if the Old Testament prophets were alive today they might dispense a message very similar to the one contained in this book. The low serotonin society is a modern metaphor that markets the book and an alleged consequence of the sins of greed, destructive envy, and vanity. Those sins are surely not new, but they may be more effectively used by modern capitalism. Maybe it is not modern capitalism that causes unhappiness, maybe it is the advance that enables modern capitalists to communicate to the masses.A professor of history taught me that the world is rushing madly in two directions: it is rapidly getting better and simultaneously going to the dogs. Melville Ulmer, an economist taught that as long as the markets are open to all, there will be corrective influences. Unlike Jeremiah and perhaps James, neither of them promised me a rose garden.Herbert S. Gross, M.D.

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