|Year : 2021 | Volume
| Issue : 2 | Page : 100-109
Could Our Species Usefully Become Social Psychiatry's 21st Century Scientific Concern?
Robert E Becker
Drug Design and Development Section, Translational Gerontology Branch, Intramural Research Program, National Institute on Aging, Baltimore, MD; Aristea Translational Medicine Corp., Park City, UT, USA
|Date of Submission||17-May-2021|
|Date of Acceptance||09-Jul-2021|
|Date of Web Publication||31-Aug-2021|
Dr. Robert E Becker
3435 Cedar Drive, Park City, UT - 84989
Source of Support: None, Conflict of Interest: None
General Purpose: To identify evolved human social traits that undermine effective interventions against social, environmental, and other threats to health, wellbeing, and survival of individuals and our species. Methods: To identify destructive individual and group social behaviors, the author surveyed 21st century interpretations of behavioral issues raised in primatologists studies of chimpanzees and bonobos. Drawing from a wide range of physical and social sciences, he then selected specific issues regarding health, wellbeing, and survival for study in humans. To test functionality, concepts were challenged for implications. To explore practicality, applications were identified and models for possible clinical and policy use were developed. Results: Analyses identified specific impediments to effective human responses to threatening or otherwise challenging circumstances and their implications. Using two models for psychiatric interventions, the author explored potentials for intervention against the involved dysfunctional behavioral traits. Conclusions: An evolutionary biological phylogenetic focus clarifies why humans experience dysfunctional traits as a result of evolution. This provides a broader, important grounding for further psychiatric research and development of interventions.
Keywords: Environmental loss, evolutionary biology, evolved dysfunctional behavioral traits, psychiatric intervention
|How to cite this article:|
Becker RE. Could Our Species Usefully Become Social Psychiatry's 21st Century Scientific Concern?. World Soc Psychiatry 2021;3:100-9
| Introduction|| |
Evolutionary biology presents social psychiatry with new opportunities to address human wellbeing. Humanity's current crises with their environments reveal evolutionary flaws in how individuals and groups function with one another. Resulting insights into familiar distortions in how humans experience their existence offer psychiatry new perspectives. These perspectives on evolved human social traits inform our understanding of the substrates of psychiatric diseases, of persons' everyday problems of living, and of potential public health and patient care interventions that may be available to psychiatry. This new evolutionary biology perspective is consistent with the 1948 World Health Organization's Constitutional conception of health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” and the 1964 World Social Psychiatry objective to understand the interactions among “individuals and their physical and human environments.”, As such evolutionary biology opens new areas of scholarship and research not currently considered relevant to psychiatry, yet with consequences for the public and for a social psychiatry.
Recent research, from the cognitive sciences, psychology, economics, evolutionary biology and related fields, irreversibly integrates the health, wellbeing, and survival of human individuals and populations with their social and physical environments. These insights from the arts and sciences, especially evident in Darwin's evolutionary biology, confirm social psychiatry as potentially a comprehensive medical brain science and practice addressing impediments to health, wellbeing and survival. As a science of individuals and populations, living in and dependent for survival on social and physical environments, social psychiatry becomes concerned with how individuals and populations interact with their social and physical environments. The disabilities incurred from known mental illnesses, from traditional threats from the social environment–stereotyping, racism, genocides, wars and so forth–and from our current environmental and pandemic risks become of interest and concern for a social psychiatry that acknowledges the World Health Organization's Constitution.
| Methods|| |
The author undertook a study of these issues to uncover concepts that could potentially assist our species, it sciences, and its health care providers to address both historical and current self-destructive, individual and group, social behaviors and events. I explored literature sources raised by placing these behaviors and events in an evolutionary biology perspective. Since interpretations of Darwin's evolutionary biology only stabilized as the 20th century ended, I restricted my initial search to 21st century interpretations of behavioral issues raised in primatologists studies of humans' close primate species chimpanzees and bonobos. I then used these primates destructive individual and group, social-cultural behaviors and events to identify searches for relevant human research. I selected, somewhat arbitrarily as they arose, specific issues, with analogies in primate behaviors, and studied in humans by cognitive scientists, psychologists, neuroscientists, economists, primatologists, evolutionary biologists, political scientists, social psychologists, public health leaders, archeologists, epistemologists, and other students of physical, social and cultural and related sciences. To test the possible functionality of concepts for a social psychiatry, I challenged concepts for implications regarding health, wellbeing and survival. Benefits from a concept include, for and individual or population, preventing, modifying or restoring losses from illness or injury (health criteria), lost welfare, happiness, comfort, physical, economic or other security and safety (wellbeing criteria) and loss of life from illness, accident, environment, or other adverse circumstances (survival criteria). To explore for possible utility I created, as examples, public education, policy and clinical models by which psychiatry might enable our species to address these matters on individual and population levels.
| Background|| |
António Guterres thinks that humanity in crisis needs help. His concerns are not metaphorical. As Secretary General of the United Nations, Guterres finds “Humanity is waging war on nature. This is suicidal.” He goes on to observe that “Nature always strikes back– and it is already doing so with growing force and fury. Biodiversity is collapsing. One million species are at risk of extinction. Ecosystems are disappearing before our eyes … Human activities are at the root of our descent toward chaos. But that means human action can help to solve it.” Secretary General Guterres addresses the often cavalierly dismissed evidence of accelerating rates of environmental degradation and pandemic disease resulting from human activities. Living together in social groups, our adaptations to our environment are proving toxic for the environment and in turn, toxic for our species. Yet, these modern crises for our species are not novel threats to human individual and population self-interests. Historically humans have inflicted damage on their immediate and long-term health, wellbeing and survival. Unnecessary suffering follows from stigma, racism, gender discrimination and violence, murders, genocides, and wars that the species has successfully tolerated, recovered from and survived. Our current concerns are different. Humans, like any species, cannot survive without a hospitable environment. If our species furthers environmental degradation and exposures to pandemics, such that the environment becomes inhospitable, the species will be irrecoverably doomed. Can a scientific understanding of human behaviors explain each of these threats to our individual health and wellbeing and our survival as a species?
Psychiatry is prepared to intervene with a mentally ill person who might act on suicidal intentions and harm oneself or others. We do so because, on examination, we find some deranged mechanism that leads to this self-destructive behavior. We follow in Hippocrates' footsteps. “Whenever the air has been infected with such pollutions as are hostile to the human race, then men fall sick.” As Jouanna summarizes Hippocrates' answer, “It is necessary therefore to respond by means of a treatment that is hostile to the disease.”
Earth's air, waters and lands are being infected with pollutions hostile to the health, wellbeing and survival of the men and women who comprise our species. António Guterres effectively concludes, “human action (must) solve it.” Humans alone can modify the behaviors causing their problems. For millennia medicine has mastered pollutions that bring diseases and other misfortunes upon human individuals and populations. Drawing on this experience, psychiatry can consider identifying, understanding, diagnosing, preventing, treating and rehabilitating the human behavioral traits that foster environmental pollutions and pandemic threats. With behaviors as the source of risks from inherited human traits, medicine and society will look to social psychiatry for scientific leadership.
Our generation would vigorously deny that climate and pandemic instabilities reflect suicidal intentions. Yet, nations have not responded to United Nations concerns as would psychiatry to a suicidal patient. Deniers of our best evidence of risks from environments and their diseases continue to act on their denials and undermine the human actions needed to resolve our species' environmental crises. Those accepting the presence of an impending crisis continue to fail to act effectively, as occurs today with the unimplemented national resolutions to reduce carbon emissions and the politically dominated responses to the Covid-19 public health crisis. Interfering behaviors, such as these instances of denial, inertia, and social divisiveness, with local, national and international profit motives, human priorities, marketing forces, profiteering and other economical, political and industrial vested interests, will require remedies and accommodations. Perhaps we are not suicidal. Unfortunately, as a species neglectful of consequences, we are vulnerable to human traits pervasive in everyday behaviors and in public policy. Our species' human relations may well need a social psychiatry focused both preventively and therapeutically beyond diseases and impairments.
| Results|| |
Life, environment, and the Second Law of Thermodynamics
For millennia mental illnesses and aberrant social movements have been accepted by the public as deviant forms of behavior found in individuals and populations. Studies of the behaviors of bonobos and chimpanzees support an assumption that analogs unacknowledged aberrations more pervasively affects the human species.,, Deteriorating environmental conditions over decades predict that humans cannot safely sustain the progressive damage we are doing to Earth's environments; yet we sidestep responses., Since Hippocrates, medicine has recognized the dependence of the public and patients on the health of their environments. Jouanna observes how “One of the most important ideas of Hippocratic medicine, in fact, is that the natural environment of a place has an influence upon health and disease.” Darwin found species dependent on and evolution responsive to hospitable environments. Rudolf Clausius and Lord Kelvin, in formulating the Second Law of Thermodynamics pointed to the danger for life from the disorder or entropy inherent in organisms' internal and external environments. In mid-20th century Harold Blum made these risks explicit. The ability to reverse disorder enables life. Increasing disorder or entropy, not time's passing, ends life. Energy requirements to counter entropy make an organism inseparable from a hospitable environment. The physics of life itself make it a nonnegotiable fact that hospitable environments are essential to the health, wellbeing and survival of our species (HWSS). As a biological mechanism, the physics of entropy assures that impaired or suboptimal HWSS works in many ways as an indicator of organism-environmental complementarity. As its environments, internal or external, become disorganized or deteriorate, the HWSS functions of organisms and communities will become increasingly impaired.
Why our biology is as it is
In mid-20th century, as molecular biology was gaining prominence in psychiatry, the evolutionary biologist Theodosius Dobzhansky protested against the growing hegemony of molecular biology in science. He pointed to a new dimension of analysis identified as a result of the 1930s Evolutionary Synthesis' interpretation of Darwin. In this new interpretation, Darwin's biology complements and contextualizes molecular biology. In the 1950s psychiatry turned to molecular biology for its insights into how the mechanisms of diseases function and develop. Dobzhansky's dictum, “Nothing in Biology Makes Sense Except in the Light of Evolution” draws on the then new phylogenetic context for understanding why an organism's or species' biology functions as it does: “the environment presents challenges to living species, to which the latter may respond by adaptive genetic changes.” The behavioral traits or effects of mechanisms specific to an organism develop across its evolutionary history. Why a trait's functions emerge and change in our species' ancestors, in other species and in their ancestors will inform social psychiatry about the adaptive significance of the trait for our species.
Looking to humans, to their closest cousins chimpanzees and bonobos, shared ancestors, and to more distant species, we discover how evolution leaves species unable to make sense out of the unfolding events in their lives. Chimpanzees, bonobos and other species do not have the human cognitive and linguistic capacities to grasp and negotiate with others their places in relations to events in the environment. Unfortunately, advanced cognitive powers and language enable humans to communicate broadly across social groups but fail to provide human societies with unifying social agreements able to bring peace into human lives.
Our and other species inherit lives rife with disorder and turmoil. As products of evolution, the nonhuman species live day-to-day under environmental unforgiving, survival of the fittest, conditions. Natural selection's day-to-day survival of the fittest preparedness of our and other species provides both the soil supporting and for humans, the antithesis of, evolution's conditions required for a species to survive.
The unique human environment
The evolutionary biologist Richard Wrangham has concluded that humans live in unique environments. “Human societies consist of families within groups that are part of larger communities, an arrangement that is characteristic of our species and distinctive from other species.” Homans describes the constantly unfolding social structure of these human societies. We live biologically as whole tapestries, woven by natural selection to become individuals, mutually dependent with our existing in small groups, of varying affinities and hierarchical complexities, each responsive to and affecting the still evolving human cultural and biological environments. We know ourselves and others know us as we move into, live in, and leave small groups.
Mary Parker Follett warns us against disregarding the integration present in arrangements such as Richard Wrangham describes for humans. We begin, live, and reproduce life in environments as genetic individuals, in two and two plus-sized small groups, integrated as biological wholes in emerging roles as offspring, participants and progenitors. The whole tapestry of each life, in a social group and with its environments, determines the parts that individuals and populations observe and do not observe of themselves and others. These parts, with other particular features, as a matrix determine the whole in being an individual. For Follett social psychiatry's biological subject encompasses the “totalness of the situation.” A social psychiatry seeks human “solutions in this totalness.” These solutions are hidden from view as matrices in the dynamically unfolding tapestries of lives. Particular features of individuals and populations reflect these matrices of factors, relevant to human health, mental health, wellbeing and survival.
In Wrangham's social order, the situation provides the effective social interventions called for by Secretary General Guterres to counter environmental destruction and needed by social psychiatry as behavioral countermeasures against mental illnesses and public demoralization and evolutionary disenfranchisement. Our evolution provides us behavioral problems and the social resources we have available to resolve them. Yet, in comparisons with the social lives of chimpanzees and bonobos, it becomes evident that humans inherit few social skills beyond those found in these and more distantly related primate species.
Descendants from a common ancestor
From our three species' shared common ancestor seven million years ago, to today's wild jungle living chimpanzee in Africa, natural selection has prepared chimpanzees and bonobos to survive and thrive under brutal environmental conditions. The most functionally adapted to the environment best survive and thrive socially on a daily basis. Armed initially by the common ancestor of seven million years ago with social skills better prepared for this life in the wild, humans and their ancestor species participated in creating the unique human environment. In return, this environment influenced the array of traits that humans share and not share today with chimpanzees and bonobos.
An ill prepared human species
A glimpse at how cognitive, neuropsychological and other research has characterized our species, casts new light on why humanity falters when confronted with impending risks [Table 1]. We must struggle against critical aspects of what evolution has left to us. Our evolution hides the truth from us; “we have a long history of being misled.” Nature selected our everyday experiences: of sensations, ourselves, others, qualities, forms and of concepts of space and time. In evolution they aided or were incidentally associated with the successful reproduction of our Homo ancestors and earlier species. For Donald Hoffman, Darwin puts to bed any ideas that our genetic inheritances are other than adaptations evolved blind to any reality behind what they reveal. Our evolution limits us to our only option under these conditions, an uncertain, never to be fulfilled, verisimilitude in human knowledge and actions. James Reason shows that we are extremely vulnerable to latent errors that undermine choices. Hoffman, Reason and others voice the inescapable stresses from uncertainties that are like a straw capable of breaking the backs of souls, perhaps especially those isolated from others by mental illness.
Across all human practices, all we can know is uncertain. Our assumptions will pervasively create our truths, a practice not limited to the mentally ill. As the economists Kay and King observe, with no grounds to calculate probabilities able to mitigate uncertainty in the face of novel conditions, predictions of the future become worthless. Inventors cannot foresee where technologies will lead, economists are ignorant of the future states of the economy, retirement counselors have no knowledge of future costs of living, politics, lengths of lives, and health status influences affecting an individual client. We intuitively perceive predictions based on earlier group experiences and believe them as if they could anticipate the unique lives we live as biological individuals and in unique populations comprised by individuals. In medicine, even a scientifically sound clinical trial result will not predict what a physician's individual patient will experience. We are faced by a climate change, where probabilities are realistically tentative for all and rejected by some. To best adapt to indefinite futures, we are reduced to adopting strategies “resilient to (latent errors and future) unpredictable events.”,
Evolution has all too limited our resources to counter effects from life's pervasive uncertainties. Our reasoning is rationally all too unreasonable. In our thinking and actions, we are strongly biased towards accepting evidence that will sustain our existing beliefs. We reinforce this confirmation bias with serious risks that we will overlook or otherwise reject conflicting evidence by rationalizing away its significance. Many such questionable intuitions shape our judgments and decisions. Daniel Kahneman mounts repeated challenges to any claims that our judgments and decision making can be regarded as logically rational. Our social communications rely heavily on an automated cognitive-linguistic response system in human brains. It functions to routinize individual energy investments in social relations and minimize social stress. This leaves the majority of social relations to be influenced by other than carefully reasoned arguments and judgments. Time-tested responses, familiar already to speakers, passively reinforce the speaker's existing social network relationships. With stereotyped minimum efforts, this automated response system allows social interactions to avoid cognitively divisive social interactions and their dynamics that could disturb speakers' relationships.
When a ready response does not suffice, awareness shifts to an effortful, resource-laden, cognitively more complex social response system. Here, the responder is required, with effort, to analyze and prepare appropriately crafted responses to others. As a result of the social environment that Homo sapiens shaped in its evolution, the evolved human individual genetically became a culturally involved member of a complex society. Pressured by the hierarchical social community structure of the human environment that human evolution was building for the species, evolution shaped reasoning to avoid disruptions of social relationships.
Reasoning's defers to social status
Modern human reasoning acts principally to preserve and benefit an individual's social status. Evolution did not give priority to reasoning that would logically process the stimulus generalization inferences that ground adaptive responses in even the most primitive organisms. Reasoning acts to formulate convincing interpersonal arguments and to analyze counterarguments. False positive and false negative information burdens human communicators with errors., Errors consume energy resources and undermine trust essential to the stability of social relations. For individuals and groups rationalizations flagrantly dismiss logical contradictions found in thoughts, behaviors, and arguments. The revered author who immortalized “all men are created equal,” without internal conflict over the logical inconsistencies, rationally defended his holding, selling, whipping, terrorizing and retaining as a mistress slaves. Locke's otherwise inalienable empathetic concerns for human equality could not survive the United States' Founding Fathers' rationally justified self-interested social priorities.
A second research group recently confirmed this hegemony of social relations over reasoning. Reasoning cannot function independent from resources found only in other individuals. Social networks provide sources of knowledge essential to survival of the individuals in social networks and are thereby essential to human societies and survival of individuals. With uncertainty comes the individual's ignorance of this mutual dependence. With complex social networks comes the recruiting of reasoning both to aid social stability and to use that social stability as a source of information essential to an individual reasoning effectively in relation to the community that surrounds her.
Evolutionary biology's phylogenetic studies identify distinctive human traits: enhanced cognition; spoken and written languages; and greatly enhanced technological skills. They also reveal that, in social relational endowments, humans possess few if any significant advantages over cousin chimpanzee and bonobo cousin species. Humans uniquely live amongst “communit(ies) of knowledge” sustained and enriched by the communications among the populations comprising the different and sum of complexly structured human communities. Unfortunately, human's unique, complexly interrelated communities of knowledge live with illusions of confidence that disregard how even verisimilitude is elusive and latent errors ubiquitous.,, In relation to the total knowledge available in the human community, any individual will remain relatively ignorant and unavoidably vulnerable to an illusion of understanding. Sloman and Fernbach find that, in the context of community uncertainty, individual ignorance is inevitable. We fail to recognize the depths of our ignorance of knowledge or skills that are essential to one's survival and can be fulfilled only by others. Sloman and Fernbach conclude that, in living, “we're all in it together,” which we all fail to recognize individually and collectively. Since the soundest available intelligence resides in the community, evolution's socially divisive influences only intensify the ignorance of those who choose to struggle divisively with each other. Our brains' limbic emotional and hormonal responses and cognitive overload block participation in the social networks that can support rationally and empirically informed reasoning.,,, Social divisions spurred by conflicting beliefs, across the small group structures of human societies, separate one group and society from the knowledge available from the other groups and societies.
The call to cultism
Human reasoning, by deferring to social conformism, encourages individuals to strengthen social groups by committing to shared beliefs, regardless of how outlandish the beliefs might be for nonbelievers. The nightmare of mass movements, that disrupt and undermine democratic and inclusively inclined human societies, preoccupied Eric Hoffer and led to his book, The True Believer. Hoffer describes how, by socializing truth, reason undermines, rather than defends, considerations of logical consequences from behavior. Bringing to mind Odysseus' plight confronting Scylla and Charybdis in Homer's Odyssey, fantasy, faith, and fanaticism call each insecure soul away from her individual resources to ease life's frustrations with passionate attachments to a cause. A secured but unhinged imagined future becomes an absolute balm for the believer's unfulfilled present. The desperate believer embraces fantasized certainties and delusional hatreds of nonbelievers who oppose her choices.
Whether mentally ill or a citizen at large in society, the deluded believer renounces the self and its capacities for empathetic embraces of self and others burdened with what is unknown in life. When unhinged beliefs do not interfere with the believer surviving to reproduce, blind evolution reinforces irrationality and empirical disregard. Evolution gifts to humans openness to a wide array of beliefs unfavorable to individuals and societies. Tested by natural selection as resilient survivors over generations, self-serving radical beliefs become human adaptations. Evolution's elimination of personally harmful delusions that transgress the laws of nature leave free reign to irrationality and disregard for empirical or rational consequences. Delusions of defying gravity have been purged; believers do not live to reproduce. With natural selected and culturally evolved delusions, the disaffected poison societies and their own and others' lives. Mass movements undermine constructive social relations, fragment social orders and disrupt cooperation. The neighbor becomes the other and nonbeliever, a devil to be avoided or extinguished, not an object of care and concern there to be enjoyed and appreciated.
In humans, aggression becomes savagery and despotism
Too easily and too frequently, humans under stress, ideologically bonded groups, and chimpanzees act with divisive savagery., Undomesticated active aggression in humans consumes the diversity natural in associations of individuals and divides societies with competing violence, fanaticisms, enthusiasms, fervent hopes, hatreds, and intolerance. Inclusive-empathetic embraces of differences too easily yield to rejections of what is found strange or frustrating and the movement of the disaffected into homogeneous associations of ideologically committed believers. Delusions are not the exclusive property of the mentally ill, merely an extreme consequence from evolutions endowments of the species.
To contextualize how different primate species respond to various arrays of traits, shared and unshared among humans, chimpanzees, and bonobos, Richard Wrangham has formulated an important distinction between reactive and active aggression. Across species, he reports physical and behavioral markers that correlate with domestication, the presence of reduced reactive aggression with unchanged active aggression., As recognized by Darwin, over millennia human husbandry has reduced aggression in animal species. Domestication also occurs in evolution. Richard Wrangham finds human domestication able to account for our reduced reactive aggression and accompanying empathetic-inclusive traits. As a result of domestication, we humans will not necessarily respond aggressively to aggressions toward us. Untouched by evolution is our and other species' capacities for planned active aggressions, resulting in the murders and wars we humans share with our neighbors the chimpanzees. On the other hand, the blunting and inhibition of reactive aggression in domesticated humans may play a role in individual and population accommodations to and tolerance of preposterous beliefs, divisive behaviors, accelerating savagery, and despotic leadership. In chimpanzee societies, a brutal alpha male will effectively intimidate candidate alphas males and others in the population only to later die of a coalition killing. One could expect an accumulation of reactive aggression in chimpanzees, not present with the same intensity in bonobos, but muted among humans. Our revenge is calculated not spontaneously reactive. Armed with rationalizations justifying maintaining social relationships and other traits, humans may naturally experience inertia and lack of taking action against divisive believers and aggressive leaders. Unempirical and unreasonable beliefs and practices can only persist so long as those not compliant are outnumbered, intimidated, motivated, or otherwise prevented from effectively responding. Yet, preposterous beliefs, aggressive intimidation, divisive behaviors disruptive of social collaboration and cooperation are rife in human societies.
| Discussion|| |
Rene Dubo grasps the utility in evolutionary biology for the social psychiatrist: “For the scientist a cultured attitude implies the ability and willingness to relate his field of work to historical developments, to emphasize its bearing on the future, and more generally, to recognize its relevance to other human interests” Dysfunctional evolved social traits explain Homer's Homer's Greek gods finding ironic comic entertainment in humans' tragic recklessness. In The Odyssey, Odysseus must bring new order to each of the calamities that delay his return to Ithaca. In Homer's view, what fools our unacknowledged evolutionary traits make us mortals be! Disordered by evolution, we create new disorder when thermodynamic entropy already naturally disorders our lives.
As physicians, we take an Oath to restore health, wellbeing, and survival to persons and populations afflicted by pollutions hostile to the human race. Evolutionary biological analyses reveal an array of behavioral traits that foster disorders to human social relations, [Table 1]. These human traits, hostile to the human race beating swords into plowshares, are hostile to the humanistic-scientific commitments of Hippocratic medicine. Respondents to the climate and related crises have exhorted humans to change their behaviors. The Gates Foundation has identified and emphasized the need for a wide range of environmental modifications. Global treaties the “equivalent of (a) Paris climate agreement for plastics pollution, (may be needed) to succeed” with many specific sources of pollution. The Gates Foundation is investing in the discovery of energy-efficient innovations. Such hopes quell immediate action for many. Admonitions to address environmental losses go largely unheeded. The human inherited behavioral traits that undermine the required responses identify potential target for social psychiatric study and intervention.
Psychiatry potentially can offer at three levels interventions aimed at mitigating the negative influences that evolved human traits exert in individual and group decision-making. Through individual, policy, and public education interventions, a social psychiatry can interpret how and why our species' behavioral genetic predispositions act as impediments to collaborations within and across societies. A comprehensive social psychiatry, deriving its priorities from the brain's functional compromises to HWSS, can undertake preventive, treatment, and rehabilitative interventions with individuals and patients. A physician, practicing preventively by regarding each patient as a failure of prevention, could address air pollution or other environmental threats with a mother and a community concerned for her child.,
Psychiatry as a profession could more closely collaborate with other disciplines to develop research, teaching, services, policy, and public education programs relevant to moderating or mitigating our species' undermining individual and group members' self-interests. In these ways, such a group could work with governments to overcome resistance to interventions against threats such as climate change. Our problem is to soundly ground the preventive, treatment, and rehabilitative practices of medicine with scientific evidence. We can understand how economic, cultural, religious, political considerations pressure public servants to support constituents' interests. What social psychiatry is asking is that we make a policy commitment of government to unequivocally support, with regard to the public's health, wellbeing and survival, evidence-based health interventions, including new efforts to modify past and current self-destructive group-social-cultural behaviors and events.
Social psychiatry can provide public education into specific evolved traits and their consequences for what it is to be human. Given the obvious harms associated with the currently identified and possible other evolved socially divisive behavioral traits, and the possible utility of psychiatric individual, population, and public policy and education interventions, evolutionary biology provides new challenges and opportunities for social psychiatry to explore.
Evidence dynamically links inherited traits in thinking and acting to divisive social practices, such as stigma, stereotyping, prejudice, intolerance of diversity and nonschismatic beliefs, malicious beliefs, genocide, murder, wars, and possible irretrievable losses of environment hospitable to human life.,, Evidence scientifically grounds, in the human genome, traits that functionally put individuals at risk of cognitive distortions and social misperceptions found symptomatic in mental disorders, but also active in the absence of mental disorders. Frustrated, our domesticated but trait-infected species spontaneously turns to evolution's unmodified active aggression. This only furthers divisive fragmentation of social orders. History has shown the unnecessary destructive costs from evolution's preservation of active aggressive behaviors in our empathetic-inclusive informed species. Our species is capable of empathetic concern and caring for others, as are our primate cousins. Our species is capable of a more phylogenetic grounded and informed psychiatric nosology and therapeutics. The public is capable of rejecting irrationally grounded mass consensus movements as being delusional. Our species has access to cognitive-emotional resources that can foster empathetic care and concern for others, inclusive decision-making, break free from ideologies, and reinforce the complex, hierarchical social bonding and networking required by our uniquely human social structure.
Just as medicine learned to reduce diabetes by controlling body mass; psychiatry, by fostering in the species uses of empathetic, inclusive, concerned, and caring social decision making, can learn to reduce active human divisiveness and aggressions, their long-term social, environmental, and other consequences in everyday life, and their disordering effects for the mentally ill. Some features in human evolved behavior are dauntingly socially disruptive and divisive. Traits lead actors to generate a wide range of dysfunctions: the wealth disparities that create a welfare state for the wealthy and leave others as victims of a predatory capitalism; mental health services that serve the self-identified patient and leave the severely mentally ill without care homeless on public streets; a psychiatry with current biochemical and psychopathological assumptions that exclude consideration of challenging problems of living resulting from evolved behavioral traits; a view of empathetic love as spontaneously emotional and beyond consciousness rather than a mutual trust reached in reciprocated cognitive commitments to caring and concern for the other. Evolved human reasoning betrays all of us by rationalizing its biases. Our human reasoning favors uncriticized, divisive parochial social consensus and neglects our requiring a functional inclusive cognitive hegemony over acts from emotional and other behavioral traits. The human condition invites more intense scrutiny by a socially informed psychiatry.
On the other hand, social psychiatry interventions will face daunting problems of implementation: individual and institutional self-interests; commercial profit motives; human appetites; marketing forces; science rejection; profiteering; a range of cultural and ethnic beliefs and practices. Individuals' evolved dysfunctional traits themselves will undermine the effectiveness and potentially even the reception of this approach by governments and psychiatry itself. While none of these factors successfully challenges the validity of the science, a needed fuller understanding must await further investigation and confirmations of the claims. Understanding the personal and population mechanisms that bring harms to mental health, health, wellbeing, and survival does not ensure public or even professional compliance. Yet, for those not ideologically adamant science deniers, information about the self, inherited in being human, provides useful empirical evidence supporting behavioral changes difficult for persons and populations.
Obstacles are many and daunting. Yet, with real risks of irreversible damage to the environment, has psychiatry any reasonable options but to address human recklessness hostile to humans' best interests? Once again, the arts inform scientists of their obligations. In science, as in art, if leave out of our story “something because (I) do not know it, the story will be worthless.” Like art, science proceeds with the scientist aware that, due to the pervasive uncertainty in human experience, innocent oversights potentially compromise any hypothesis' verisimilitude. In the future, new knowledge will negate every hypothesis. In this context, social psychiatry importantly learns to differentiate lapses in verisimilitude due to inattention, repression, discretion, and deception, seen in some mental illnesses and everyday socialization, from the inherent structural uncertainty introduced into all human beliefs and acts by our evolutionary heritage. I propose that evolutionary biology opens new frontiers for social psychiatry.
| Conclusions|| |
An evolutionary biological phylogenetic focus clarifies why humans experience dysfunctional traits as a result of evolution. This furthers the contributions of how traits affect human experience, provided by current biological science. Understanding the development of behavioral traits important for our species' wellbeing provides a new perspective for social psychiatry to understand mechanisms of behaviors and their development among the public and with the mentally ill. Evolutionary biology's insights challenge social psychiatry to support individual patients, affect health policy and inform the public why some natural inclinations are dysfunctional for individuals' and groups' best interests. Complementary how and why biological explanations can inform the public how, in ways, we have been blindly ill prepared by natural selection for the unique social environments in which we must survive. Psychiatry's phylogenetic translations of research into evolved impediments to effective social action promise a useful supplement in the struggle against environmental degradations and will refresh our understanding of sources of personal and public stress for psychiatry's patients. Social psychiatry can potentially become the 21st century science of evolutionary impediments to human social adaptations.
Homo sapiens may mistake these products of blind evolution as unavoidable human traits not potentially reversible. Left by evolution responsible for itself, Homo sapiens finds itself overburdened, not suicidal. As a species, evolution has adapted us to reproduce successfully. Evolution, in adapting us to survive and reproduce, has not adapted us to live in health, wellbeing, and as individuals or groups, to survive. Evolution has left the tasks of human wellbeing to medicine and its social psychiatry. We have choices. Any remedy is in human hands. Addressing evolved behavioral traits opens a new perspective for a comprehensive social psychiatry of human relations. It is in our individual and species interests for social psychiatry to address the human impediments to reversing environmental damage and to understanding factors that historically and still currently undermine human health, social wellbeing, and survival.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
World Health Organization. Constitution. Signed on 22 July 1946 by the Representatives of 61 States (Off. Rec. Wld Hlth Org., 2, 100), and Entered Into Force on 7 April 1948. Available from: https://www.who.int/about/who-we-are/constitution
. [Last accessed on 2021 May 05].
Blum HF. Time's Arrow and Evolution. Princeton, NJ: Princeton University Press; 1955.
Bradshaw CJ, Ehrlich PR, Beattie A, Ceballos G, Crist E, Diamond J, et al
. Underestimating the challenges of avoiding a ghastly future. Front Conserv Sci 2021;1:615419.
Breaths VI. In: Loeb J, Hippocrates II, editors. Hippocrates. Cambridge, MA: Harvard University Press; 1981.
Jouanna J. Hippocrates. Baltimore, MD: The Johns Hopkins University Press; 1999.
de Waal F. The Bonobo and the Atheist. New York, NY: W. W. Norton and Company; 2013.
Rosati A. Chimpanzee cognition and the roots of the human mind. In: Muller MN, Wrangham RW, Pilbream DR, editors. Chimpanzees and Human Evolution. Cambridge, MA: The Belknap Press of Harvard University Press; 2017.
Wrangham RW. The Goodness Paradox. New York, NY, Vintage Books; 2019.
Dobzhansky T. Nothing in biology makes sense except in the light of evolution. Am Biol Teach 1973;35:125-9.
Mayr E. The Growth of Biological Thought: Diversity, Evolution, and Inheritance. Cambridge, MA: The Belknap Press of Harvard University Press; 1982.
Homans G. The Human Group. New York, NY: Harcourt, Brace and World; 1950.
Follett MP. In: Metcalf HC, Urwick L, editors. Dynamic Administration: The Collected Papers of Mary Parker Follett. New York, NY: Routledge, Taylor and Francis Group; 2003.
Hare B, Wrangham RW. Equal, similar, but different. In: Muller MN, Wrangham RW, Pilbream DR, editors. Chimpanzees and Human Evolution. Cambridge, MA: The Belknap Press of Harvard University Press; 2017.
Boyer P. Minds Make Societies: How Cognition Explains the World Humans Create. New Haven, CT: Yale University Press; 2018.
Kahneman D. Thinking, Fast and Slow. New York, NY: Farrar, Straus and Giroux; 2011.
Hoffman D. The Case against Reality. New York, NY: W. W. Norton and Company; 2019.
Kay J, King M. Decision Making beyond the Numbers: Radical Uncertainty. New York, NY: W. W. Norton and Company; 2020.
Hoffer E. The True Believer. New York, NY: Harper and Row, Publishers; 1950.
Reason JT. Human Error. Cambridge, MA: Cambridge University Press; 1993.
Becker RE. Two cultures in modern science and technology: For safety and validity does medicine have to update? J Patient Saf 2020;16:e46-50.
Sapolsky RM. Behave New York, NY: Penguin Press; 2017.
McLean P. The Triune Brain in Evolution: Role in Paleocerebral Functions. New York, NY: Plenum Publishing Corperation; 1990.
Kirsh D. A few thoughts on cognitive overload. Intellectica 2000;1:19-51.
Haidt J. The new synthesis in moral psychology. Science 2007;316:998-1002.
Mercier H, Sperber D. The Enigma of Reason. Cambridge, MA: Harvard University Press; 2017.
Sloman S, Fernbach P. The Knowledge Illusion: Why We Never Think Alone. New York, NY, Riverhead Books; 2017.
Wilson M, Glowacki L. Violent cousins: Chimpanzees, Humans and the roots of war. In: Muller MN, Wrangham RW, Pilbream DR, editors. Chimpanzees and Human Evolution. Cambridge, MA: The Belknap Press of Harvard University Press; 2017. p. 464-508.
Dubos, R. The Dreams of Reason. New York, NY: Columbia University Press; 1961.
Wilson E. The Odyssey. New York, NY: W. W. Norton and Company; 2017.
Gates B. How to Avoid a Climate Disaster: The Solutions We Have and the Breakthroughs We Need. New York, NY: Alfred A. Knopf; 2021.
Nature Editorial. Chemistry can help make plastics sustainable – But it isn't the whole solution. Nature 2021;590:363-4.
Becker RE. Psychiatry's past can be psychiatry's future. J Nerv Ment Dis 2021;209:85-7.
Prunicki M, Stell L, Dinakarpandian D, de Planell-Saguer M, Lucas RW, Hammond SK, et al.
Exposure to NO2
, CO, and PM2.5
is linked to regional DNA methylation differences in asthma. Clin Epigenetics 2018;10:2.
de Waal F. Mama's Last Hug: Animal Emotions and What They Tell us About Ourselves. New York, NY: W. W. Norton and Company; 2019.
Becker RE. Psychiatry and the 21st
Century: Reworking the DSM. J Nerv Ment Dis 2021;209:398-401.
Johnston KG. Hemingway and Freud: The tip of the iceberg. J Narr Tech 1984;14:68-73.
Becker RE. Biology's contributions to social psychiatry's future. World Soc Psychiatry 2021;3:14-21. [Full text]