Carr, D.Worried Sick: How Stress Hurts Us and How to Bounce Back. New Brunswick, NJ: Rutgers University Press. 2014116pp £12.99 (pbk) ISBN 978‐0813565378

Abstract

Worried Sick is an odd little book. I was intrigued by it, and having read it, I confess to being unsure how to begin my review, apart from to assert that it is an odd book. This slim volume comes from the Rutgers University Press ‘PinPoints’ series on ‘Complex Topics, Concise Explanations’. This may explain its unconventional approach and form. The four other texts in the series include a book on Black icons and others on the economy of New Jersey, environmental crisis and water shortage, and dark matter. Set against these titles Worried Sick looks unusual, but not incongruous. The PinPoints brief is to deliver material for ‘a wide circle of scholars, students and non-specialist general readers’ in 100 pages and Carr sticks to these page limits. And as to content, well, it was interesting to read a book on stress not written by a health psychologist or from a psychotherapeutic stance. Deborah Carr is a Professor of Sociology at Rutgers where she teaches and conducts research on family life and the effects of stressors such as bereavement, so I wondered if a sociologist's fresh examination of the topic would contradict biomedical explanations of stress and our responses to it. In as much as this is possible in such a short book, Carr does this. In essence, the book presents a biopsychosocial (BPS) model that highlights the interconnectedness of biology, psychological, economic and social factors that create and may protect against stress. As a side note, David Pilgrim (2015) has written about the popularity of BPS amongst health researchers that provides a fuller account and critique of this model. Carr's book straddles the popular science, self-help and introductory sociology genres such that it is not always clear who the actual audience will be. Worried Sick might find its way to the mind/body section of the book store, where the sub-title promise of ‘bounce back’ solutions might not be misplaced, but I was not sure quite how comfortably it would fit in the sociology or health sections. Questions of product placement aside, the book is a good summary of the topic and an interesting, quick read. The book ‘feels’ very American, in part because of Carr's attempts to personalise the message with vignettes and stories about ‘Dawn’, ‘Naomi’, ‘Marisol’ and ‘Rob’ in the manner of populist therapy books. This is reinforced by evidence drawn from US sources, learning that ‘16% of Americans have ever suffered from a major depressive disorder’ (p. 25) and 18% of them have experienced anxiety in the past year (p. 27). It was not until half way through that a study of ‘ninety thousand adults in the United Kingdom’ – linking mental state and mortality – was mentioned (p. 50), but this was not referenced, making the book a slightly frustrating academic resource. Carr provides an outline of the historical definitions of stress, going back to Hans Selye's endocrinological research in the 1950s, and reviewing contemporary measures and scales, but also noting ideas about stress contagion in social networks. She reviews, albeit briefly, various theories about the links between stress and health - covering role strain, cumulative disadvantage, stress process and discrepancy theories - and contrasts these with bio-genetic explanations for the complex relationship between mind and body. Carr mentions survey and laboratory experimental research methods before examining ‘social science explanations’ for the connection between stress and health. There are a couple of pages each on (damaging) heath behaviours, nudges to alter these, and the impact of sleep on mental wellbeing. This precedes a section on ‘Social Class: The Fundamental Cause Behind the Stress-Health Link’ which briefly takes in fundamental cause theory and the impact of social inequality, before the book returns to Seyle's physiological work. The fourth and penultimate chapter examines ideas about risk and resilience, and the conclusion explores ‘Paths to Healing’. This notes the benefits of social support for behaviour change, alongside cognitive behavioural therapy and mindfulness. There is a relatively short section on medications, which – given their ubiquity and cost, and interest to social scientists – might have warranted a longer and more critical appraisal. That said, Carr concludes that ‘most of the stressors discussed in this book have their roots in major social inequalities based on one's social class, race, gender, age or even body size’ (p. 108) and argues that public and social policy can support these stressors, or address them to improve population wellbeing. That seems to be a message worth repeating.