Health Books: How to Stay Sane by Philippa Perry
Actionable advice based on neuroscience on keeping your sanity. A clear guide to help you understand your inner workings and improve your mental health
What does it mean to “be sane”? That’s what I dove into the past week. I’m glad I did because, lately, I’ve been feeling like I’m losing my mind ;) In this newsletter, I’m sharing what I learned from the book How to Stay Sane by Phillipa Perry.
The Cambridge Dictionary describes it as “having a healthy mind and not mentally ill”. But what does that mean? Perry gives a clearer example of what it means to be sane: When you find a balance between two extremes of being “rigid and stuck” and “chaotic and out of control”. It’s about:
“How to remain stable and yet flexible, coherent and yet able to embrace complexity.”
With this in mind, let us look at how Perry helps her readers maintain (or reach) that point between two extremes.
A mental health guide based on neuroscience
Perry focuses on helping her readers understand their brains better as she believes that to improve our mental health, we first need to understand how our minds work.
In neuroscience, researchers look at the brain as a combination of three parts: the reptilian, mammalian, and neo-mammalian. Alternatively, these parts are called the brain stem, right brain, and left brain, in the same order.
The reptilian brain is in charge of reflexes and involuntary muscles. This part is already fully developed at birth and makes our hearts beat and eyes blink when they see sudden movement.
The right and left brain develop in the first years of our lives through experiences. During this process, neural pathways are created. These pathways are necessary for our brain to make connections and handle all the processes involved in what we say and do.
How we use our right and left brain
During our first two years of life, the right brain leads us. It’s in charge of our emotions and instincts—how we interact with others, feel about ourselves, and comfort ourselves in distress.
After the initial phase, the left brain becomes more active—handling language, logic, and reasoning. But the right brain remains in charge. In short, the left brain handles communication and executing plans. It’s the part that puts our thoughts and feelings into words and carries out actions.
Although many people think we are rational beings, Perry emphasizes that we’re actually emotionally driven. Our logical, left brain follows our emotional, right brain. In that sense, mental health forms the basis for a happy, healthy life.
As long as our instinctive brain is out of balance, the entire brain is influenced by this and we will struggle to handle life. Or in other words, to stay sane. But the wonderful news is that our brains are flexible. We can make up for what was missing in our right brain development during the first years.
Four areas of change
We can continue developing our right brain throughout our life. The foundation is laid in the first two years but that doesn’t mean it is set in stone. Perry shows us ways to rewire our right brain to handle life better.
How to Stay Sane introduces “four areas of change” through which we can improve our mental health:
Self-observation
Relating to others
Stress
Personal narrative
“Change” doesn’t mean we are becoming a different person. Rather, we become more aware of who we are and change our ways to be more aligned with ourselves.
“Change happens, if it needs to, when we become aware of what we are, not when we try to become what we are not.”
Observing oneself is like parenting oneself
Self-observation is a good starting point for better mental health. We need to know ourselves to know others. The main goal of this area of change is increasing self-awareness—a lifelong process.
One way to view self-observation is by comparing it to a parent observing their child and correcting behavior when they think it’s necessary. Perry says that when we self-observe we reparent ourselves.
Our right brains were developed through interaction with our parents or other caregivers. Similarly, we can mimic this process by parenting ourselves. For this, it’s important to be accepting and non-judgmental. The goal is to increase understanding of our feelings, sensations, and thoughts.
The Grounding Exercise
Perry recommends starting observing yourself through the Grounding Exercise. By asking yourself questions, you become aware of the state of your inner world. We either reference externally or internally; we focus on how others see us or how something feels. The Grounding Exercise helps us focus on what’s going on internally.
Self-observation can be very simple. You ask yourself what you are feeling, thinking, and doing; and you observe how you are breathing. Next, you ask yourself:
“What do I want for myself in this new moment?”
In short, the Grounding Exercise helps us understand our feelings and emotions, which is what we need to understand our words and actions. You can also compare this exercise to a check-in with yourself.
Post-rationalization is not rational but emotional
After self-observation, most of us move unto “post-rationalization”. We need to organize our thoughts regularly to avoid getting overwhelmed by them since our internal and external worlds are highly complex. However, the reasons we give to explain our behavior are not based on logic but rather on our emotions.
Perry’s research concludes that “we are unable to make any decision without our emotions”. She refers to studies in which participants no longer had a functioning emotional (right) brain1. The participants couldn’t make any decisions even though the logical (left) brain was still working.
“Certainty is not necessarily a friend of sanity, although it is often mistaken for it.”
By explaining the mechanisms of human rationalization, Perry shows why it’s important to practice self-observation: We need to understand our feelings to understand our motivations.
Our brains need other brains
To stay sane it’s important not to get stuck in our inner worlds. Our brains need other brains. We need interaction with others to maintain our mental health.
Although the basis for our right brain is laid by the people we interact with during our first years, interactions with others continue to shape our brains throughout our lives. That’s why it’s important to keep seeking out healthy socialization to stay sane.
Through mutually open interaction, our brains create new connections. It’s important that we can be ourselves and fully present in the exchange. In such stimulating environments, the brain structure changes for the better.
To form healthy relationships, we need to remain open and flexible. Social interaction can’t be tied to a set of fixed rules. We all have different cultural concepts and unique personalities. What one person sees as acceptable social behavior, might be seen as rude by another.
We need to be aware that we cannot connect deeply with everyone. Instead, it’s important to stay open to meeting new people to find someone we can build a lasting relationship with. For this, we have to be willing to be vulnerable to truly connect with others. And it’s crucial to keep seeing others as human beings—not objects.
Bad versus good stress
The next area of change is stress. Though stress is often seen as entirely bad, there’s also so-called “good stress”. This is the type of stress Perry writes about. We need good stress to grow and to change for the better. She explains “‘good stress’ promotes the neural growth hormones that support learning.”
But which stress is “good” and which “bad”? This is different for every person. The Comfort Zone Exercise (see below) is one method Perry recommends to find out what counts as good stress for you. We need to discover which activities provide the middle way between too much and too little stress.
With good stress, our brains are stimulated but not overstimulated. Mild exercise like walking or stretching is also a great example of providing healthy stress.
The Comfort Zone Exercise
All human beings have a comfort zone—a mental space that contains all situations we feel completely comfortable with. Outside of that zone lie all scenarios we are unfamiliar with and that take courage to undertake.
Perry recommends doing a Comfort Zone Exercise to get more comfortable with unfamiliar situations to broaden our horizons and have a richer life. Below is an example of this exercise.
First, you draw a circle where you write the things you feel completely comfortable with. Next, you add a circle with activities that take more effort to accomplish. Then you add another circle with goals you find really hard to achieve. You can add as many circles as you want.
To start expanding your comfort zone, you try activities that lie closest to the inner circle. Like that, you take small steps toward personal growth without overwhelming yourself.
What stories do you tell yourself?
Lastly, stories play a crucial role in our sanity. As Perry puts it:
“Part of staying sane is knowing what our story is and rewriting it when we need to”.
Our reality is formed by stories—by narratives we tell ourselves and others tell us. This starts from the moment we are born when we hear the words our caregivers repeat to us. The stories we are told form the basis of our beliefs and our approach to life. We make sense of the world through narratives.
But these stories are not written once and then stay the same forever. We keep adding to them throughout life. We can even change the stories or write new ones. This is how our narratives are another area of change.
To give an example: I grew up telling myself the story I’m not creative. I heard it from the people around me and copied it from them. The more I told myself this, the truer it became. Until I became aware of what I was doing—partly because some people acknowledged my creativity—and changed the story.
I changed the narrative to “I am creative” and saw my creativity increase. People around me also noticed and their recognition reinforced my new belief. This is how stories change our lives. You influence your quality of life significantly with the stories you tell yourself.
Put the book to practice with seven exercises
How to Stay Sane includes a workbook at the end with seven exercises so you can put what you learned into practice. This is a great way to move from just reading theory to actively improving your mental health.
1. The One-Minute Exercise
This exercise is to help you focus on only one thing: Your breathing. For one minute, you concentrate on your breath without changing the way you were breathing. Whenever you wander off, you direct your focus to your breathing again.
2. The Thirty-Minute Exercise
With this exercise, you gain insight into your thoughts. You become aware of your thinking patterns by doing it weekly. Sit comfortably in a quiet space without distractions with a notebook and a stopwatch.
For 30 minutes, you allow thoughts to come and go freely. Note down each thought in one or two words and then let it go and focus on your breathing again.
Once the stopwatch goes off, you sort the thoughts into categories and note down the total thoughts per category. This shows you the type of thoughts you think most and where you could direct more focus.
3. A self-observation exercise to do whilst working
Pick a chore or a daily activity you do, like washing the dishes or eating a meal, and practice self-observation while you’re doing it. For instance, while you’re showering, direct focused attention to each action, sensation, or thought:
“Now I open the shower door… I hear the door sliding open… I feel the shower floor with my bare feet… etc.”
Doing this exercise helps you learn self-observation and intentional living.
4. The Focused-Attention Exercise
During this exercise, you sit in a quiet space and focus on your five senses, inner, and physical sensations, and your thoughts and feelings. The best way to do it is to listen to a recording of yourself or someone else slowly directing your attention to different elements.
You switch between focusing on your breathing and sensations in and around you. By regularly practicing focused attention, you train yourself to direct your attention as you want.
5. The 1 2 3 4 Breathing Exercise
Sitting or lying down, you focus on four breathing phases: Inhale, top of in-breath, exhale, and bottom of out-breath. By counting each breath, you become aware of where you breathe more deeply and where more shallowly.
You will also notice each breathing phase makes you feel differently emotionally. Perry replaces each number with a mantra:
I take from the world
I make it my own
I give back to the world
I come back to myself
These phrases make you aware of how you interact with the world around you. You can apply emotional experiences to the four breath phases to more carefully analyze how you’re feeling about them.
6. The Crowded-Place Exercise (Feeling, Thinking, Acting)
Perry writes that people are either feelers, thinkers, or doers. Everyone feels, thinks, and acts but one is more dominant than the others.
The Crowded-Place Exercise helps you discover which “being zone” you’re in most. It also shows you how you can balance the three zones more to maximize their potential.
For each being zone, you finish a set of phrases about what you would feel, think, and do in a crowded place. Afterward, you analyze what you wrote down by answering questions about it.
7. The Genogram Exercise
With a Genogram you map out your family tree on paper. Apart from names and dates, you also add information about the type of relationship between the different family members and their main characteristics.
The aim of the Genogram is to gain insight into patterns within your family line. Our ancestors influence part of who we are and what we do, so we can understand ourselves better by learning more about them.
Perry’s Genogram focuses on mental health within the family and the relations between the members. You can also use it to map out behavior patterns and character traits.
You can find many examples online to determine how to make a Genogram. This overview of Genogram symbols by Olive Me Counseling is also very helpful:
What I learned about myself
For me, Perry’s book was quite an eye-opener. I learned a lot about myself and have discovered ways to improve my quality of life. These were some of my realizations:
I’m more internally than externally focused
Up to now, I was missing relation to others and relied almost exclusively on self-observation, so I should focus on increasing relating with others to find a healthier balance in life
I already practice self-observation enough, but I can improve how I do it. I was lacking awareness of the feelings that were driving my reasons—I will benefit from learning to look at the deeper, underlying reasons for my behavior
I hope this book review helps you learn about yourself and improve your life too. Looking forward to keep learning together!
See Descartes’ Error: Emotion, Reason and the Human Brain by Antonio Damasio