IF LIFE GIVES YOU LEMONS, MAKE LEMONADE. GIVING MEANING TO LIF B o o k r e v i e wPapeles del Psicólogo / Psychologist Papers, 2017. Vol. 38(1), pp. 79-80 http://www.papelesdelpsicologo.es http://www.psychologistpapers.com 79 n times of tension, publications, courses, therapies, drugs and commercial inventions abound (some with scientific basis and others without), inviting us to live without stress (without fear, overwhelm, sadness or “nerves”, etc.) or at least keep our stress levels under control, as something feasible and of course desirable, however Ernesto Lopez and Miguel Costa offer us the exact opposite: to learn to live with stress (with fears, overwhelm, etc.) Even more, the authors suggest that we contemplate stressful life situations, and the discomfort that they trigger, unavoidable as they are, as an opportunity, based on the acceptance of this suffering, to guide us to take practical action, despite the stress, towards the objectives that we consider valuable and that give meaning to our lives. This approach, which is found within contextual therapies or third generation therapies, and especially in acceptance and commitment therapy, inspired the book that I’m reviewing here. Stress, far from being defined here by activation, anxiety or distress (which are inherently linked to life), is defined as a type of situation that one experiences, a way of relating to the environment, a contingency system based on negative reinforcement (experiential avoidance), which alleviates in the short term but leads to an impoverishment of the life repertoire and a deepening in discomfort. The problem is not in the suffering, but in the counterproductive actions that are implemented in the vain attempt to alleviate it. This approach is not intended to merely eliminate or relieve distress, but rather as the book’s subtitle says, to give meaning to life when stress and anxiety complicate it. In my view, this change of objective has enormous depth. Firstly, because it considers that suffering is part of life and not something we should not have, despite the fact that the approach of psychopathology and its commercial derivations insist on useless and counterproductive efforts to suppress it, so the objective cannot be any other than acceptance. As the poet Ángel González (quoted in the book) says, you need to be very brave to live in fear. Secondly, this change of objective is important because it confronts those of us who experience stress with a question of great importance: what you want to do with your life? Or, if you like, what things are important to you? Or, in more operational terms, what are the goals that give meaning to your life and are worth starting despite the difficulties? In the therapeutic situation the question of personal values arises, perhaps in a different way –easier to answer–, but substantially it is this: it is like learning to live in a different way, guided by what really matters to one (and this is different for each individual) and not by the everyday and useless combat against discomfort. Wow! Based on this general approach, set out in the introduction to the book, in Chapter 1 (Como la vida misma [Like life itself]) a transactional concept of stress is developed, defined as the result of the imbalance between the sources of stress and the coping resources. According to this transactional vision, an overview is offered of the main sources of stress (stressful events, more and less predictable life changes, illness) and especially of the variables that make an event more or less stressful (imminence, duration, uncertainty, predictability, lack of control, ambiguity). A refreshing review is also included of the basic paradigms of learning (vicarious, classical, instrumental and in the relational framework), which are central to understanding this phenomenon but are often forgotten in other texts. With the transactional concept of stress established, Chapter 2 (Un torrente de energía que nos hace vivir y nos puede hacer sufrir [A torrent of energy that makes us live and can make us suffer]) is a concise, clear and attractive overview of the complex physiological processes involved in the stress response, their adaptive value, and at the same time, the potential health problems that can occur in the various systems of our body. If the problematic element of the experience is stress avoidance, as established at the beginning of the book, the strategy to follow in order to live with it and suppress its limiting effects is precisely exposure and active coping. The rest of the book is devoted to developing the particular aspects and the clinical implications of this strategy. Thus, Chapter 3 (Exponerse y afrontar: obras son amores [Exposure and coping: works are love]) is dedicated to exposure to the sources of stress. First of all, it is important to stress that this exposure to stressors and private events does not only seek the elimination of conditioned anxiety responses, as occurs in IF LIFE GIVES YOU LEMONS, MAKE LEMONADE. GIVING MEANING TO LIFE WHEN STRESS AND ANXIETY COMPLICATE IT López, E. y Costa, M. Madrid: Pirámide, 2016 José Javier Moreno Arnedillo Madrid Salud. Ayuntamiento de Madrid I Correspondence: José Javier Moreno Arnedillo. Subdirección General de Prevención y Promoción de la Salud. Madrid Salud. Ayuntamiento de Madrid. España. E-mail: morenoajj@madrid.es R e v i s i ó n d e l i b r o s 80 classical behavior therapy (a limited and negative objective because it seeks to remove something) but also to send the individual in the direction of what he or she considers valuable in life (a broad and positive objective because it seeks to build a direction, a course of action). Unlike the model of the cognitive behavioral approach (change the thoughts in order to change the act), the primordial role of action is insisted upon, which alters the system contingencies: behavioral change occurs precisely by changing the behavior. The chapter includes a welcome review and several practical guides to refresh the knowledge of the old techniques of “first generation” behavior therapy, such as systematic desensitization or flooding. Chapters 4 and 5 are oriented along the same lines. Chapter 4 (Si la vida nos da limones, hagamos limonada [If life gives you lemons, make lemonade]) discusses exposure and acceptance of the physiological and emotional aspects of the experience of stress. Chapter 5 (El poder de las palabras y sus verdades y mentiras [The power of words and their truths and lies]) covers the role of language, which due to its ability to replace the direct experience can be a help but also a trap. It can be a trap because it can be a source of stress, but above all, because it can have a paralyzing effect on action. Consequently, it is about questioning the literalness of certain verbal rules (the “shoulds”, the “needs” and the “ifs”, etc.) and, once again, exposing oneself to real contingencies. The chapter concludes with a guide for self-instructional training. The context is largely the social context, formed by the people with whom we live and with whom we communicate, with greater or less luck and skill. Learning to live with the sources of stress involves particularly learning to handle social situations. Interpersonal communication can be an intense and pervasive source of stress, but it can also be a buffer for stress, which leads us to consider the vital role of personal skills for interpersonal communication. Chapter 6 (Comunicarse para afrontar el estrés [Communicate to cope with stress]) is dedicated to developing this issue that is so crucial. Far from the orthopedic approaches, it is the biographical and contextual nature of behavior that allows us to understand the meaning of the core strategy of validation and the principle of interdependence. It includes an invaluable practical guide, of some length, to enhance basic communication skills such as listening, empathy, expressing agreement, knowing how to say no or managing criticism and expressing emotions. If stress is a transaction between the context and the individual, one of the pillars for coping with it is by making changes in the environment. The whole of Chapter 7 (Rediseñar el ambiente, rediseñar la vida [Redesigning the environment, redesigning one’s life]) is a practical guide on how to intervene in contexts in order to live better with stress: by reducing or eliminating the sources of stress, leaving the situation, seeking information on the source of stress, redesigning the home, redesigning organizations or workplaces, organizing the agenda, delegating etc. and, from a more general perspective linked to behavioral activation therapy, procuring a healthy lifestyle, full of lovers, that makes life richer and more satisfying. Finally, Chapter 8 (Respirar hondo, relajarse y dejarse estar [Taking a deep breath, relaxing and letting yourself just be]) is a very detailed practical guide on breathing and relaxation techniques, along with an invitation to mindfulness and enjoyment of the present moment, in line with the approach of mindfulness. It is, therefore, a concentrated self-help manual related to stress, in which each issue covered is linked to the model and the general strategy outlined in the first chapters. From there, it goes on to offer an abundance of practical guides, such as the ones already mentioned. Each of these guides is an invaluable effort of synthesis, sometimes one or two pages long, of the key practical issues to consider when performing a particular procedure. I would like to emphasize that the practicalities are “intertwined” throughout the theoretical development, going fluidly from theory to practice because both dimensions, far from being opposed, involve each other: the theory is the guide to action, and action builds theory. Nothing to do, therefore, with recipe books. On this matter, the restoration, almost the rescuing, of the techniques learned in the first manuals of the 1960s and 70s is notable. These techniques constitute what is now known as first generation behavior therapy (systematic desensitization, flooding, participant modelling, stress inoculation, assertiveness training, relaxation, environment enrichment, etc.) although they are now incorporated, with renewed shine and in a different context, but with the same conceptual coherence, into the third- generation therapies (Acceptance and Commitment Therapy, Behavioral Activation, Mindfulness, etc.) Finally, I cannot resist making a reference to the relationship between the book and the biography of the authors, who are still young but already in the age of jubilation, as they like to say. Apparently Pablo Picasso once said it had taken him a lifetime to learn to draw like a child. I believe this idea is applicable to this book. Throughout the whole book there is a flavor of a living thing, something practiced, ideas born out of action, and action in various fields of application of psychology. Somehow this book is the result of a process of “distillation” (I cannot think of a better metaphor), in which the knowledge accumulated about stress, the science of behavior, therapy and various other issues has passed through the alembic of the experience of the authors and they have produced this result. It requires a long and personal professional and productive journey to be able to communicate so simply, so accurately and in such an enjoyable way. I believe that without this biographical baggage it would not have been possible to write this book, at least not in this way. It is noteworthy, for example, that the book lacks a bibliography, and literary references (Kipling, Carroll, Cervantes, Salinas, Quevedo, Confucius, Machado, Borges, Kafka and many others) are more abundant than scientific ones (all solid and well chosen), and that both types are integrated effortlessly within the flow of the current text.