Book Review: Alex Korb’s The Upward Spiral

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Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time. Oakland, CA: New Harbinger Publications, 2015, 225 pp.

Review by Ted Alston, facilitator

Bad feelings and bad habits fly together, and evasive maneuvers for one may serve for both. Accordingly, students of SMART Recovery may enjoy this book that addresses depression. Alex Korb, PhD, is an expert on neurotransmission, but he presents a model permitting self-management and and self-empowerment to have roles in mental health. In this model. a prescriber might help someone with a medication molecule that modulates neurotransmission, but readers have the power to choose other reasonable tactics that are non-pharmacological but have neurotransmission aspects.

Korb puts forth the important and attractive concept that neuroscience does not doom anyone to depression or addiction, nor to various other conditions with labels. He emphasizes that we all have pretty much the same instrument of thought and behavior. Whatever genetic or experiential differences may be, the troubled brain is usually out of tune rather than defective. Korb has a gift for analogy, and I do not want to spoil the encounters of his readers with those gems, but I will mention one. I liked when he said, “There’s nothing wrong with your brain, just like there’s nothing wrong with the air in Oklahoma–despite the devastating tornados.” This excerpted quote might seem inscrutable, but Korb’s full argument is easy to follow.

Korb offers much advice that is in line with the philosophies of SMART tools. For instance, a section of Chapter 2 is subtitled “The ABCs of Anxiety.” The Korb ABC is different from that of Albert Ellis, but it rhymes. One could delete all of the neuroscience from the Korb book and be left with a practical and reasonable pamphlet collating many SMART concepts. However, Korb offers a lot more than that. His every point includes a rationale based on what is known about neuroanatomy and neurophysiology. The book is intended for a broad audience, so the science depth is limited. However, the work is a superb introduction to neuroscience. Even a professional neuroscientist might appreciate the book for Korb’s power of explication.

Pharmacological and procedural therapies are beyond the scope of SMART Recovery, but the subjects are of wide interest. This book is a great introduction but does not attempt to handle issues such as the potential for adverse effects. However, too much information would have detracted from the superb readability. Consequently, there are a few glib statements. For instance, electroconvulsive therapy “increases BDNF, which helps grow new neurons.” (BDNF is a protein called Brain-Derived Neurotrophic Factor.) Anyway, ECT is not a focus of the book. Korb has much more to say about other antidepressant strategies, such as cultivating social interactions. According to Chapter 10, boosting gratitude is just the thing for your serotonin. Be that as it may, from a SMART standpoint, grateful beliefs tend to be more rational, helpful, and realistic than ones of ingratitude. And considering your gratitude is a way to examine your beliefs.

Albert Ellis spoke of bibliotherapy for depression and other disturbances. David Burns cited a study showing that the act of reading his book Feeling Good has a measurable antidepressant effect. Korb suggests that a read of Upward Spiral is one small but appreciable change away from depression. The suggestion is plausible.

We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org

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