Stress and the City


Nature explores the question of why the incidence of psychosis is more than double in urban environments than in rural, attributing it to stress.

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].


  1. From the article “they carry risk genes” . Yeah its a genetic disease to not like living in a polluted and dangerous city, where our ancestors never lived in a city. They are insane. Are they going to breed men and women to be Trolls? Those that like to live underground , breath pollution, and dig out shiny objects?

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  2. I can only speak from my own experience but yes, cities drive me mad. I can’t tell if it is genetic or not.As someone who had been traumatised by war in my early childhood,I grew up in small villages, at the heart of nature, in Germany and in France. Then after teaching French in beautiful,friendly Austria for 3 years I ended up in Canada. It was a horrendous shock; the endless ratrace: people driven non-stop by their ambitions, work, commuting, no time for friendships, hardly seing any daylight during the winter, no time for oneself, always exhausted. I was earning 10 times more than in Europe but I soon decided that it was not for me and returned to Europe because the american way of life was driving me crazy and my sanity was important to me. I am not surprised at all that city-living, without the possibility of escape, is driving some people insane: it all depends on what one wants from life: is that genetic?

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