Qincent Deary, psychologist, fatigue specialist and author, told me what an “anxious creature” he is. He barely slept last night. The hotel room was unfamiliar and noisy. Worse, the prospect of an interview and meeting someone new made his arrhythmic heart pound.
It’s racing now as we sit together in a London hotel. We are here to discuss his new book, How We Break: Navigating the Wear and Tears of Life, an exploration of our different responses to the corrosive pressures of daily life, especially work, and an assertion of the essential necessity of rest, recovery, and the lost art of recovery. The book is the second in a trilogy by Deary, a professor of psychology at Northumbria University and a clinical fatigue specialist at the Cresta Fatigue Clinic, a role he has just retired from. The NHS clinic, which is closing later this year, is unique in the UK in taking a multi-disciplinary approach to tackling fatigue. Deary goes on to share something else with me: he fears the intimacy of dinner and hates surprises, before adding that his partner of 10 years recently threw a surprise party for his 60th birthday—and he loved it. It turns out that people can change.
Well yes and no. Deary believes we can make changes, if circumstances permit, and we can adapt, but we cannot fundamentally change the self we were born with. First, there is our genetic makeup. Then, he says, there is our constitution, which is coded with memories of previous generations and sometimes through intergenerational trauma; the body remembers, it keeps count. Deary presents himself as a good example of this, and there are three other case histories in the book, including that of his late mother.
On turning 40, long since amicably divorced, Deary left his job as an NHS therapist, sold up in London, moved back to Scotland, and assembled material for the first book. Five years later, he became a single parent when his 16-year-old daughter came to live with him. The finished book folded in a drawer, Deary lacking the confidence to seek publication. How to live, the first book in the trilogy, was finally published when he was 50. Now he was also a writer, an acclaimed one. Lots of changes there then.
But who he is has not fundamentally changed, he says. “I still have social anxiety.” What he has managed to change is his relationship with this anxiety: “I recognize that it is part of me, that it is going to appear, so I now literally bring it with me as a companion. And that’s right. It might mean that I’m hyper and talk a lot, but that can be very helpful.”
For Deary, getting to this place of self-acceptance and self-love was a project, it was work and that’s okay, because we each have to work on the self we were born with in order to survive, or thrive. Some, like Deary, will not be suited to their environment, meaning “some of us are working harder on ourselves than others”. We “tremble” when we encounter the turbulence of life, including the changes we must navigate, but, again, some of us tremble more than others. In turn, holding firm in the face of change, known as the allostatic load, becomes too much: “There’s no wiggle room and we break,” as Deary himself did while writing his new book has.
As part of his work on himself, Deary traced the reach and roots of his anxiety, as he does for his patients in the fatigue clinic. Early on, he “meets” a female child growing up in a working-class culture on the west coast of Scotland and sees what a “misfit” he was. He ran with the “rejects and the freaks”.
“I was visibly different from my peers,” he tells me, “very gentle, gentle. I was small and scared by nature. This is not necessarily great in a working class comprehensive in 70’s Scotland. There was bullying. I was called either snobby or poof. I wasn’t one.” He had a big nose and was called Concorde. “My body remembers the early threats; I still get startled easily.”
So was his mother. Gentle and open-minded, she had a punitive upbringing and, like her son, had an “anxious constitution”. Deary was an “unexpected pregnancy,” he writes, his mother already dealing with a large family and the wear and tear of poverty and a troubled marriage. “I was born scared,” he writes. But the house was good. “I had quite an exceptional mother,” he says, “and an exceptional home life. We were inculcated very early in art, literature, theater and that therefore marked us out as different. I didn’t come from a typical Scottish family came to the west coast.”
He shares his story in the book, not “to say I had a really hard time, but because I wanted people to resonate – I wanted them to see that when you didn’t fit in, you gave back to yourself becomes as work because you have to learn to manage what doesn’t fit. You have to learn to manage the difficult feelings that arise from it and you have to learn to manage yourself.”
The key to that self-management is not only understanding and self-love, but rest. Deary has a mantra: work needs rest and rest needs work. We need to take time to rest to heal from extreme exhaustion, chronic illness, or unexpected life events, which Deary calls “biographical disruption.” We also need to take a break from work and free ourselves from an “audit culture” that sometimes pushes us to breaking point. But first we must learn how to rest. “It’s a skill,” he says, one that needs to be learned these days.
“One of the things I’ve noticed in the fatigue clinic is that tired people can often do the things they need to do, but a lot of them really struggle to switch off. We often associate our worth and our value in terms of productivity and output. Both within academia and the NHS there are entire mini-industries dedicated to evaluating your productivity and your output, often telling you that you can do better and, in fact, you can do better with less, please. It’s very easy to buy into that narrative that your work equals your productivity. So, for people who are exhausted and can’t be productive, it’s very easy to go, I don’t deserve to rest, I’m worthless, I didn’t do anything to deserve it.
“But we have to allow ourselves to rest, to sleep, to enjoy, to deliberately switch to joy and nourishment and the things that actually fill the tank. I wrote this book to understand myself, but also because in the last few years I have seen friends, family, colleagues, society to some extent just become overwhelmed, or exhausted, or hopeless or joyless. Ordinary people going through ordinary suffering. Some of them crossed the clinical line into physical or mental health systems, but most of them were just struggling to get on with life. Often the first victim of stress is joy. Intentionally leaning into that joy and finding the things that restore you is really the key to recovery.”
Some GPs have begun to dispense joy as a “social prescription”. But how do we identify what brings us joy? “The clue is in our everyday language: ‘It really lifted my spirits’ or ‘I got a lot out of it.’ These are the things that cheer us up or give us energy.” A meal with loved ones is often high on the list. Deary’s academic research looks at the challenges facing head and neck cancer survivors. “It’s not the food they miss,” he says, “it’s the part. They mourned the connection. This is what we call commensality: that social magic that comes when you share food. Our research with food and head and neck cancer and other conditions has emphasized that pleasure is a necessity; to be deprived of it is literally depressing and demoralizing.”
One day, halfway through writing How We Break, Deary discovered this himself. He “woke up in a state of exhaustion. I had no real ability to get out of bed. When I finally took myself for a walk, I was wiped out the next day. I was in a state of hopeless exhaustion. My mood dropped too. I was completely disconnected from life. It was a very difficult time.”
To recover, he did “what I help people do in the fatigue clinic, which is to gradually get back into my own pace and do a combination of physical and emotional rehabilitation. Incremental involvement in life. I think that is what true recovery is. It’s not just rest and it’s not just activity, it’s that mix of both: it’s recognizing that there is a deep need for rest and recovery. It’s like Thomas Mann’s Magic Mountain where they all sit in the sanatorium: there is the beauty, there is the bandage, there is the food. There is the joy” – even in an interview. “A joyous meeting!” was Deary’s verdict, glad he had come, proud of himself and proving that a little self-love goes a long way to lighten the wear and tear of life.
How We Break: Navigating the Wear and Tear of Living by Vincent Deary is published by Allen Lane on January 25 at £25. Buy a copy of guardianbookshop.com for £21.25
