The British Journal of Psychiatry
Feeling Good: The Science of Well-Being
C. Robert Cloninger
Raj Persaud

Cloninger, a distinguished US psychiatrist, starts this book with the question, ‘why is it so difficult to be happy’? He is critical of conventional scientific psychiatry's approach to the answer to this question, and throughout the book invokes concepts which science finds it difficult to grapple with - like ‘coherence’. He ranges with profound insight widely over philosophy and history plus many other sciences, including mathematics, to take an intelligent stab at the central problems of well-being.

At the heart of the dilemma over human well-being, Cloninger argues, is one of many fundamental conflicts, like that between reason and emotion. Freud also believed the good life arrived when we used our reason to overcome emotion; indeed he advocated a ‘combative’ stance indicating the vigorous and active nature of the clash at the centre of our quest for betterment.

Whatever you might think about Cloninger's conclusions, which include the argument that the very reductionism at the heart of science confounds its ability to unlock the secret of human happiness, he is making a vital more general point about a fundamental predicament at the heart of our profession. Psychiatrists trying to heal depression or other forms of suffering without a clear sense of where well-being is located, are a bit like someone giving directions to the lost, but by knowing only where you don't want to go.

Certainly again, Cloninger is surely right that contentment must have something to do with our relationship with others and with the wider material world. We have to live in some kind of harmony with our social and physical environment.

Unlike many others who consider happiness seriously this book takes a more strategic view. That I do this thing this decade, and that thing another decade, in order to arrive at a place eventually resembling happiness. The strategic view involves incredible foresight and very long-range planning - something economists are much more used to in their theorising than modern psychiatrists preoccupied with cognitive-behavioural therapy.

Cloninger has also devised a unique technique for ‘measuring thought’ which grades the quality of one's thoughts along a continuum from baser, more unhappy-oriented thinking - characterised by lack of trust and lack of flexibility - to higher levels denoted by coherence, patience, compassion, reverence for God (piety) and awe of God. He shows how his technique can be applied to the writings and speeches of others and demonstrates how a personal journey toward fulfilment can therefore be charted.

Many secular practitioners might find this otherwise useful book's concern with spirituality difficult, but the key conundrum for me with the work is the lack of more explicit engagement with an obvious paradox at the heart of well-being. In the long and tortuous journey towards the achievement of any worthwhile ambition, from which contentment subsequently derives, there is usually an enormous amount of suffering - it is the ability to tolerate and not be afraid of pain that actually underpins true bliss. Yet the very obsession with pleasure that characterises modern society is an indicator of intolerance for and rejection of distress. The paradox at the heart of happiness is that you are going to have to experience anguish in order to get there - you need to embrace the one thing you are trying so desperately to avoid.

Distinguished scholars like Cloninger are perhaps persuaded by publishers to sugar the pill by obscuring this central truth, after all the upbeat title of this book is Feeling Good. Maybe at a fundamental level our very corporate culture is unable to engage with and promulgate key truths about the human predicament.