Month: March 2019

Chemo as an Analogy & Analogies in General

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Recently I came across a striking quote from Tolstoy, “Religion is a philosophy which can be understood by anyone.” I think I would get rid of the “a”, and just say “Religion is philosophy which can be understood by anyone.” And it’s possible that since the original is in Russian, that this second version might be closer to Tolstoy’s actual intent. Though, in any case, it was actually the second half: “can be understood by anyone” which really struck me, given that it’s a point I’ve made myself on occasion. There are in fact a lot of philosophies out there, and some of them are pretty good, but not all of them can be understood by anyone. When I have made this point previously, I used rationality as an example. This is a philosophy I have significant respect for. But which, I argued, can only be understood and adopted by a select few, and this significantly diminishes its utility, and the utility of other, similarly arcane philosophies.

To put it in more concrete terms, let’s imagine that in a pre-philosophical Hobbesian war of all against all, that if you have 10,000 people that they will commit 100 murders. To combat this you come up with two philosophies: philosophy A which can be understood by 10% of people and philosophy B which can be understood by 90% of people. Philosophy A is 100% successful at stopping its adherents from murdering while philosophy B is only 50% successful. If we assume, for the sake of our example that you can only adopt one philosophy or the other then philosophy B is objectively better since it will reduce the murder rate to 55, while philosophy A will only reduce it to 90.

We might wish for more people to adopt philosophy A. You might try to make philosophy A easier to understand. But in the end, ease of understanding and adoption turns out to be just as important as how effective the philosophy is at preventing murder. Now, of course, this example is vastly over-simplified. For one, we are not restricted to choosing only one philosophy, we could have the 10% who understand it, follow philosophy A and another 80% follow philosophy B, leaving 10% who can’t understand either, which gives us a murder rate of 50. Which is better, but observe that it’s not that much better than the pure philosophy B approach of 55.

There are obviously many other oversimplifications inherent in this illustration. For example the idea that the philosophies can be implemented independently. That we can force people to adopt the best philosophy they can understand as if by fiat. When in reality philosophies end up in competition. Also simplifying things around the issue of murder, when in reality we expect our moral philosophies to lessen all manner of crimes. Conceivably a philosophy could be great at preventing murder while being bad at preventing, say, slavery. But despite all of this I would argue that the point it makes about understanding and adoption is both valid and critical. And further that, because of the simplicity of the example, we may in fact be understating the importance of actual adoption.

If we make the illustration more concrete and assume for the moment that philosophy A is atheistic rationality, while philosophy B is generic Christianity, then there appears to be very little evidence that atheistic rationality is twice as good at preventing murders. (The 100% success rate vs. the 50% rate in the illustration.) In fact there is considerable evidence, depending on how closely you want to tie people like Stalin and Mao to that philosophy, that it is considerably worse. That particular argument is not one I want to have right now, but I think, at a minimum it calls into question any argument that it’s better. In fact I would go further and argue that it’s unlikely we’re going to invent something that’s markedly better than religion at preventing all of the things which are widely accepted as crimes. Which means that ease of understanding, or as Tolstoy says, “a philosophy which can be understood by anyone” is the most critical feature. Which is why religion is so important.

Now, if, as in the illustration, two philosophies could exist comfortably side by side, and both were equally effective, than we might not care. But as I said, in reality there appears to be unavoidable competition between philosophies. For example, it would be hard to argue that atheistic rationality hasn’t significantly eroded the adoption level of organized religion. If it had replaced it with something equally effective that would be one thing, but it’s not clear that it has. Once again this is not an argument I want to have right now, rather I just want to point out that it may be difficult to have multiple competing philosophies all operating in the same space.

The final point I brought up related to how well a given philosophy deals with all possible examples of immorality, not merely one extreme example, like murder. And I think it’s in this space that those opposed to traditional religion would lodge their strongest objections. Even if most philosophies are roughly equal at preventing murder and theft. They would argue that traditional religion is much worse at protecting things like LGBT rights, or a woman’s right to choose. I bring this up to be fair to the people making these arguments. They are good arguments. But they are once again arguments I don’t want to have right now (though I believe I’ve addressed them at length elsewhere.) The point of this post is to discuss how important ease of adoption is when judging the value of a philosophy. (Also, I would point out as something of a parting shot that I think most of the issues where current philosophies are perceived as doing better than traditional religion end up being more complicated than it’s advocates claim.)

Everything I have discussed so far is partially a long-winded way of examining the questions: what should I talk about in this space? And how should I talk about it? As I have pointed out recently it’s very easy to come up with a clever analogy, tie it into some recent anecdotes, and call it wisdom. Whether it’s actually wisdom is up for debate, but it’s certainly not science. Is that a problem? Should I be more scientific? Should I dispense with analogies and make these posts as scientific as possible? Include footnotes to supporting journal articles, caveat everything with confidence levels, only talk about things where there’s a preponderance of evidence? There’s absolutely a place for that, and certainly things which claim to be scientific should make sure they’re actually engaged in science. But science brings a host of problems when you try and transform it into a philosophy for life and then slot it into the space previously occupied by religion.

Right as I was in the midst of writing these words I saw a tweet from Taleb which pithily summed up the problem:

If there is someone spreading statistical illiteracy & naive empiricism, it is @sapinker.

Statistics is hard.

Of course being a tweet it has to be part of some twitter feud, in this case it’s the long running battle between Steven Pinker and Taleb. But that also is part of the point I’m trying to make. Breaking out the points of the tweet:

  1. “Statistics is hard” – This is true not only of statistics, but all of science. And many people have followed the best advice of the scientific experts only to find out later that it was entirely wrong. Nutritional advice is a great example of this.
  2. “Naive empiricism” – Closely related to above many people naively champion what they claim is science, without understanding things like replication, second order effects, or the filters through which the scientific knowledge has passed before it gets to them.
  3. The accusation against Steven Pinker. If we choose to believe Taleb, that even Harvard professors engage in naive empiricism, then what chance does the bulk of humanity have in understanding and adopting a scientific philosophy? Even if we disagree with Taleb, it’s clear that in the absence of religion most people don’t turn to rationality and science, or if they do it’s selectively in confirmation of the biases they already have.

To sum all this up I think there is a real need for things that can be “understood by anyone”. My contention would be, particularly with respect to long standing religious injunctions, that they’re going to be at least as good if not better than any of the more modern philosophies which attempt to improve on morality by being more rational or scientific, because religion is easier to understand and apply. And this is why I’m going to continue to put forth analogies, speculative philosophy and other similar stuff. Yes, I may be wrong. (Which I have never been shy of admitting.) But I think it will be both easier to grasp why I might be wrong, and also easier to understand how I could be correct.

Accordingly, the foregoing basically amounts to a long strange defense of using analogies in my writing, while, furthermore, building to a discussion and dissection of one particular analogy, which I’m going to use as something of a stand-in for all analogies.

This analogy is something a friend of mine came up with. He brought it up recently in a conversation we were having about politics. He called it the chemotherapy analogy. When someone with cancer undergoes chemotherapy, everyone knows that some healthy, non-cancerous cells are going to die along with the cancerous cells. The hope is that they can eradicate all of the cancerous cells before killing the patient. (Question: Do you have to get every last cancer cell to prevent it from returning? This will be important later.) Thus a balance must be struck. Make the chemo too potent and you may unnecessarily kill more healthy cells than necessary; you want it just potent enough to sufficiently eradicate the cancer and no more.

The analogy part comes if we imagine that people or ideas could represent a cancer on the body of the nation (perhaps even civilization as a whole?) In eradicating the cancer we have to be careful about how aggressive we are. If we’re too aggressive we may not only “kill” some healthy ideas, but we might kill the patient. If we’re not aggressive enough then we still risk the death of the patient, but this time it will be the cancerous ideas that kill him/her, not the aggressive treatment. Initially this struck me as a useful way of looking at things, but in an attempt to be more thoughtful, rather than just presenting it, I thought I’d go farther and dissect it.

As I said I was initially struck by some of its strengths, so I’ll start there. To begin with you can never have too many analogies about the inevitable tradeoffs that come with any policy. Yes cracking down on certain forms of speech will almost certainly target people who should probably be silenced, but that crack down will also probably silence people who shouldn’t be silenced, people who have useful contributions.

The fact that cancerous cells are hidden among healthy cells is also a strength of the comparison, since bad actors are spread out among honest citizens. In cancer the ideal situation is to catch it early when it’s small and localized and the prognosis for a surgical excision of the cancer is still good. I think we hope the same thing can be done with dangerous people and ideas. That we can find a small cell of radicals and deal just with them in a surgical strike. Additionally although chemo does harm healthy cells it’s designed in such a way to be disproportionately harmful to cancer cells. In the same way while there is the possibility of unduly punishing the innocent, all of our methodology is designed around targeting cancerous people and ideas without harming the healthy. Tying this all together we could say that the methodology of treating cancerous cells and cancerous ideas bear a lot of similarities.

At some point, though, we have to move on from methodology as metaphor to deciding what constitutes our metaphorical cancer. Here I think the analogy becomes less useful. I am sure that there are people on the left who feel that white supremacists and their accompanying ideology is a perfect use of the analogy. You have something that started out as a tumor (the Confederacy) we tried to surgically remove the tumor (the Civil War), but we didn’t get it all. It continued to fester and metastasize until now it’s everywhere, and it’s only through the application of really aggressive chemotherapy that we have any hope of eradicating it. And yes occasionally this very aggressive chemo is going to target people it shouldn’t. (Though they would argue this is incredibly rare.) But it’s our only hope if we’re going to save the patient.

On the other side you could argue that excessive immigration is a form of cancer. Here we start with the premise that a certain level of cell division and renewal is healthy and expected, and that this represents the level of immigration where immigrants are eventually assimilated. But just as cancer occurs when cells start to divide uncontrollably, overwhelming the healthy initial cells, immigration can become a metaphorical cancer when the immigrants stop assimilating or when immigration starts to overwhelm the initially healthy patient. People who like this version of the analogy are not opposed to all immigration, but they are in favor of assimilation rather than multiculturalism while also feeling that there is a level of immigration which could be excessive. That in this version chemo might keep out some worthy immigrants but that it’s necessary because you can’t let in everyone who wants to immigrate to America, there are just too many.

Of course, there might also be disagreement in who the patient is. In the most recent example it’s clearly the United States. But in the first it seems like it could be equality and progress regardless of the country. And, as I reflect, I realize that there are people who were already using cancer or at least disease as an analogy, but with the patient as whole earth and humanity as the disease. As an aside, this latter analogy is interesting because it lends itself naturally to the idea that just as humans run fevers when they’re sick that global warming is a similar phenomenon with respect to the Earth. I’m not sure what the metaphorical chemotherapy would be in this example. Nor do I think, as a human myself, that thinking of humanity as a disease is particularly helpful.

I also wonder if the idea of cancer, which reproduces uncontrollably, wouldn’t take us in the wrong direction? In the past I have talked about Robin Hanson’s contention that the modern world represents something of a Dreamtime. That many of our habits and behaviors are profoundly non-adaptive. One example of this is the fall in reproductive rates. Which is to say our “cancer” may have nothing to do with out of control reproduction at all, but rather a long slow death spiral where humanity effectively gives up on reproduction. This takes us to my next question, what does it mean, metaphorically, for the host to die?

We know when an individual has died, but what does it mean for a nation to die? Surely even the most conservative can agree that we have already changed quite a bit as a nation, that we are not the nation we once were and that much of the change has been positive. Have we already died and been reborn countless times? And if so, is fearing yet another death silly? That said nations and civilizations do die, and it’s not very pretty when they do.

On the other side I could see where killing progress, which is presumably the driver of beneficial change, might seem objectively more worrisome, but I also have my doubts that the battle lines are so clearly drawn. Or that what we mean by “progress” or “progressive” today is exactly the same or exactly as efficacious as what those words once meant, say 50 or 100 years ago. But I am sympathetic to those for whom progress = a healthy society.

Still, to completely flip it around, it’s interesting to use the difference between healthy cell division and uncontrolled cell division as a metaphor. Is it possible that progress was once essentially healthy cell division, but that, as it became more extreme, it transitioned into some form of cancer? That rather than worrying about societal cancer killing progress, we should be worried that a modern conception of progress is the cancer? Before you dismiss this idea entirely, recall that however abhorrent conditions were in the past with respect to slavery, violence and equality, that they did not “kill” the patient. The claim that we need to use radical chemo on the patient to fight them now when all three are objectively better on nearly every metric, seems misguided. Recall that people die sooner than they would have otherwise because of chemotherapy all the time.

Having dealt with what may or may not be metaphorical cancer, I’d like to briefly take a deeper look at the treatment. I asked earlier whether we need to eliminate every last cancer cell or whether it was sufficient to beat it back to a certain level. I’ve always assumed that it’s impossible to get rid of every last cancer cell, that you merely needed to get it down to a level where the body’s natural defenses could stay on top of it. But I realized as I was writing this, that I wasn’t sure (nor was a Google search particularly illuminating). I bring it up because it feels like in the current culture war/metaphorical chemotherapy we’re engaged in that there is a contingent of people who believe we can’t allow even a single potential bad actor or bad idea to remain. This is perhaps where the metaphor is at its strongest, as we repeatedly see ideas that are largely benign if unfashionable set upon with the full fury of our metaphorical chemotherapy. And yes, perhaps these healthy cells have to be destroyed in order to also get the actual cancer, but I kind of suspect that they don’t. In fact, I would actually argue that if we do have a cancer it’s one of those slow-moving types that are better to leave alone because you’ll die of natural causes before the cancer kills you. Where the cure is worse than the disease. 

In the end what are we left with? Is there any wisdom in this analogy? Does it help us make the decisions required of us going forward? I think, as we saw, it’s an analogy that might be used by either side to make them feel more justified in doing what they were already going to do. Obviously that’s a point against it. Also as I made clear, there’s zero science involved in it either, in fact in my description of cancer I have probably distorted things rather than clarified them.

Still despite all of this, I think anyone who made it this far has a different way of thinking about trade-offs and tactics in the current culture war. And is hopefully less inclined to indiscriminately apply metaphorical chemotherapy. Perhaps they have also done some deep thinking they might not have otherwise done. If nothing else, coming up with reasons why I’m wrong. Finally the multiple possible interpretations may, in fact, be a strength. For myself, I think I’m slightly more sympathetic to those who see bigotry as a cancer which threatens the engine of progress.

To toss in just the tiniest amount of religion, there’s a reason Jesus taught in parables, and I would strongly contend that parables, analogies, metaphors, etc. are still useful. Plus at this point, I’m starting to feel like we can’t take anything off the table, particularly any tool which makes people and conflicts easier to understand, and hopefully empathize with.

Allow me to present the parable of the grateful blog reader, who came upon someone blogging in the desert and who gave him water, bound up his wounds, set him on his own beast, brought him to an inn, and donated.

A Psychological Hygiene Hypothesis?

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I talk a lot in this space about antifragility. For those who need a reminder it’s the idea that certain things get better/stronger in the presence of stress. For a really in-depth explanation see my post on The Ideas of Nassim Nicholas Taleb who discovered the idea. (In the same way that Columbus discovered America i.e. it is something which has always been there, but he brought attention to it and named it. And yes, I know that Columbus didn’t name America, but he did name the Indians.)

I am not the only person to discuss antifragility, and nearly any time someone does they bring up the hygiene hypothesis, because it’s such a great example of the principle in action. This includes me, but on previous occasions I didn’t go into it in much depth. I’m going to start this post by rectifying that.

The hygiene hypothesis, as originally formulated by David Strachan, speculated that a lower incidence of childhood infection translated into higher rates of hay fever and asthma. From the beginning Strachan noticed that family size was a factor as well, More brothers and sisters provided more avenues for childhood infection. But that still leaves the question of why a lack of childhood infections would map, later, to a greater incidence of hay fever and asthma?

Initially it was thought that it was mostly things like measles, the flu, and other childhood diseases that were the primary culprits, but then Graham Rook came along with the “old friends” theory. From Wikipedia:

Rook proposed the “old friends hypothesis” which some claim offers a more rational explanation for the link between microbial exposure and inflammatory disorders. He argues that the vital microbial exposures are not colds, influenza, measles and other common childhood infections which have evolved relatively recently over the last 10,000 years, but rather the microbes already present during mammalian and human evolution, that could persist in small hunter gatherer groups as microbiota, tolerated latent infections or carrier states. He proposes that humans have become so dependent on these “old friends” that their immune systems neither develop properly nor function properly without them.

Hay fever, asthma, and other allergies are products of overactive immune systems, and while the clinical details of the hypothesis would take us into the weeds of TH1 vs. TH2 cells and much more besides, I don’t think it’s over simplifying things too much to describe it this way: The immune system needs something to target, and in the absence of historically harmful agents, it ends up targeting non-harmful agents, like pollen and peanuts. In the case of peanuts this reaction can be so extreme that people with peanut allergies can die after ingesting them. To return to the principle of antifragility, the immune system is antifragile. It needs stress to develop appropriately. In the absence of sufficient stress it goes a little haywire. (Or maybe a lot haywire.) To quote from Rook, “Evolution turns the inevitable into a necessity.” In this case, harmful agents were historically inevitable, and in the end they became necessary.

I find it very interesting to review examples of what the immune system considers beneficial stress (at least according to the research):

  • Large families
  • Older siblings
  • Early daycare
  • Rural Living
  • Contact with animals
  • Poor sanitation
  • Parasitic worms
  • Absence of antibiotics
  • Non-western lifestyle

As you would expect this is a list of things mostly absent from modern life, and includes some things we’ve put a lot of time and money into banishing. It’s equally interesting to review examples of the kinds of conditions that can result from not getting enough of this stress (at least according to the research):

  • Type 1 diabetes
  • Multiple sclerosis
  • Some types of depression
  • Cancer
  • Autoimmune diseases
  • Hay fever
  • Eczema
  • Asthma
  • Autism
  • Food allergies

This is a pretty nasty list, and as I already pointed out, some of the items on the list can be fatal. And if you’ve been paying attention you’re aware that most have been increasing recently. The questions is how recently. Thus far I have intentionally avoided mentioning the year that Strachan first proposed the idea, or the year when Rook amended it. But from my perspective this is one of the things that makes the hypothesis so consequential. To take a step back for a second, one of the big questions I keep returning to is how different is the modern world from the world of 50 or 100 or a 1000 years ago? The hygiene hypothesis would seem to indicate that it’s very different and that the difference is recent. The first formal proposal of the  hypothesis, by Strachan wasn’t until 1989, the year I graduated from high school. (Yep, it’s my 30th year reunion this year. I think I’m going to skip it.) And Rook’s amendment, wasn’t until 2003, and it’s gotten much worse since then. For example, the WSJ reported a 377% increase in severe allergic reactions to food just in the decade between 2007 and 2017.

Depending on who you talk to the modern world started in the early 18th century with the invention of the steam engine and the Enlightenment. Or maybe it was the late 19th century with the harnessing of electricity. Or perhaps it was the end of World War II when conflict between the great powers ceased. Or if we’re looking more in the area we’re concerned about. Perhaps it was when Pasteur solidified the germ theory of disease in the 1860s or when Fleming discovered penicillin in 1928. But all of these things still happened a long time before 1989 to say nothing of 2003 or 2007. Why is it so bad now? I understand that people are not eager to go back to having tapeworms or cholera epidemics from poor sanitation, but as best I can tell the last cholera epidemic in the US was in 1911, which as you’ll recognize is significantly before 1989.

I’m not sure of the answer to this question, nor is it the intent of this post to seek that answer. It’s just one more alarming thing about the current state of the world. Also, while the hygiene hypothesis is exceptionally interesting all by itself, I’d like to see where that idea takes us if we’re willing to expand it a little bit. Because it’s not just the immune system which experienced inevitable stress historically, all aspects of our existence were subject to inevitable stress, and I’m wondering, if we start to view these other avenues of stress as necessary does it bring any insight?

I just finished listening to The Power of Vulnerability by Brené Brown. I picked it up because I started hearing her name everywhere all of the sudden. Which I’m sure is because I started looking for it rather than some dramatic increase in her popularity over the last month. But once my attention was drawn to her I was curious to see what she had to say. My initial take is that she’s very engaging and funny, full of charisma (the thing I listened to was her presenting a six part instructional course) and I can definitely see why people would be drawn to her. I’m also very interested in her take on the benefits of guilt, but still somewhat unclear how she draws a bright line between that and shame, which as far as I can tell is the worst thing in the world from her perspective. I’m certain that I should read more of her stuff before I make any further comments, also that’s not why I’m bringing her up. I bring her up because she said something that starting me thinking about this whole subject.

At the beginning of her presentation she tells the story of two families, brothers, each of which has a wife and a few kids. Unexpectedly there is a “very violent, traumatic event”, and one of the kids dies. Obviously all the parents, and the other kids are devastated by this. Over the course of the next few years each family sends one of their kids off to war. “One comes back, one doesn’t.” Then a year after that one of the brothers loses his house after the bank forecloses on it. She then goes on to say that the story is a metaphor for the nation as a whole. The first violent event was 9/11, which was followed by the wars in Afghanistan and Iraq. Which was then shortly followed by the financial crisis of 2007-2008. That we are those families. That it has been “trauma after trauma for us.”

Brown places a lot of focus on scarcity, vulnerability and shame. This story, in addition to being a story of repeated trauma, is a story of increasing scarcity, or at least the perception of scarcity. She says that she started her research in 2001 and she has “watched scarcity, absolutely shift over this time.”

This whole thing really struck me because as disasters go 9/11 was kind of small potatoes. In the end 2,996 people died. Not to take anything away from the tragedy of those deaths, or the impact it had on those families, but I could list a dozen other disasters that are 100x or even a thousand times as bad. To just take one example, in 1976 somewhere between 250,000 to 650,000 people died from an earthquake in China. That was not even that long ago. How many people have even heard of that earthquake? And is there any evidence of permanent scarring in China? Not that I can see.

Turning to Afghanistan and Iraq, there were 6,713 US deaths. Those are also tragic, and kind of senseless, and it’s ironic that that total is twice as much as the number of people killed in 9/11. But once again, as wars go neither Iraq or Afghanistan has been particularly bad. And if that scarred us, how much more did it scar the actual Iraqis, where the low estimate for violent deaths is 151,000 against much smaller populations. And that’s just stuff that’s happened recently. You don’t have to go that far back before you start to encounter things like the Siege of Leningrad, which lasted for years and ended up killing over a million people. In fact, if you want trauma after trauma, then you should look at the Russians from the 1st World War up through the fall of the Soviet Union (and probably beyond).

Finally as far as financial crises and scarcity go, 2007-2008 was severe, but very short. Nothing as close to as deep or as long as the Great Depression. Unemployment hit 10% once, in late 2009. During the Great Depression it was above 10% for 10 years, with a high above 20%! And whatever scarcity we’re experiencing it’s nothing compared to the scarcity which exists in most of the less developed world, to say nothing of the scarcity which existed for most of recorded history.

Despite all of this Brown does have a point. As she goes on to say:

We are…The most in debt, obese, addicted, and medicated adult cohort in history.

How is this possible? How is it that Brown and her audience can look back and see “trauma after trauma”? Why do things seem so awful and hopeless for so many despite the unparalleled abundance of modern life? When the actual chance of dying from any of the trauma’s she mentioned is almost infinitesimal. (Even for people in the military it’s still pretty low.) And yes the 2007-2008 financial crisis was pretty bad, but how many people literally starved to death because of it? How many homeless people died? How many of them died because of the crisis, who wouldn’t have otherwise? And how many of those are the kind of people who show up at a Brené Brown seminar or read a Brené Brown book?

You may have already guessed where I’m going with this, but what happens if we combine Brown’s observations with the hygiene hypothesis? If we start looking at beneficial stress beyond the realm of the immune system? If we start looking at all forms of stress? Is it possible that just as our immune system has started targeting benign agents in the absence of actual infections. That our psyche has started marshaling all of its defenses against anything negative no matter how slight, in the absence of true trauma? Reacting to things that would have been inconsequential historically by going into the equivalent of psychic anaphylactic shock?

I don’t know, I want to stress that this is just me speculating. Tossing an idea out there and seeing what it looks like when I’ve actually written it down. Also, a faithful reader of this blog, did just point out to me that science is not conducted by pointing out lots of things which confirm your hypothesis, it’s conducted by looking for things which falsify it. Though yet another reader pointed out that blogging has its own set of rules which are different than those of science. And if I were to say right now that this idea is obviously false because of X, it wouldn’t be a very interesting post. (Less so…) That said I am interested in any ideas for how this concept might be falsified. I guess if true trauma continues to decline without psychological issues getting worse, or if they actually started improving that would be one way. That certainly doesn’t seem to be the way things are going, but the trend could always reverse. So while I should and will pay attention to things which might falsify this idea, I am going to spend most of the rest of this post pointing out things which I feel lend support to this idea.

To start with there’s the subject of last week’s post. The hoax Jessie Smollett pullIs that possibly an example of this? It might be, but if it is, it appears that the immune system of the entire society over-reacting, not just the psychological defenses of a single individual. Though before we dismiss it there might still be an interesting parallel.

When I imagine the immune system I imagine white blood cells swarming a parasite (and I know that this is not one of the mechanisms involved in the hygiene hypothesis). It’s possible to imagine that shameful behavior is dealt with in a similar fashion by human society. A certain percentage of individuals are predisposed, by culture and genetics, towards recognizing and shaming certain behavior. Call them scolds. And maybe some other percentage are predisposed towards giving individuals, particularly allies, the benefit of the doubt. Call them advocates. In a setting where the average group size is 150, and the percentage is, say 2%, you have three scolds and three advocates. But now that social media has allowed the community to scale up to be the entire nation, you still have individuals doing dumb (or understandable) things, but rather than three scolds and three advocates, each individual now has thousands, if not millions of each. The body is nothing but white blood cells swarming some parasite.

Let’s turn to another possible example, this one at the individual level. The other day I was out to lunch with an old friend of mine and he mentioned that he was having financial troubles. He had been working as a chef, but finally the lack of opportunities for further advancement and the long hours were just too much and he had to quit amidst declining health. He got another job working at a big plumbing supply store, and he’s doing a lot better, but he’s not making as much money and his kids are in the expensive stage of life (i.e. teenagers). Both he and his wife agree that the obvious solution would be for her to start working, and his wife is willing, but she claims that her social anxiety prevents her from working most traditional jobs. She has made some attempts to find a job that would allow her to work from home, but has so far been unsuccessful. (I should mention at this point that I have altered details of this story to protect the identity of the wife.)

In the past there have been times and conditions where if you didn’t work you died, and people, presumably, never said during those times that they couldn’t work because of “social anxiety”. This leaves us with a few possibilities.

  1. Social anxiety is just an excuse, she doesn’t want to work for some other reason. She’s lazy, or she is secretly hoping her husband will divorce her, or something similar. This is certainly possible, but based on my conversation with her husband, and my slight acquaintance with her, I don’t think she’s “faking it”, but you never know.
  2. If she was really in danger of death or some other horrible consequence (e.g. homelessness) she would work, but absent that her anxiety is too powerful to overcome. If this is the case then it could be that social anxiety has always been present and it’s just the consequences of not working which have changed. That said, their situation is pretty dire, for example they will probably lose their house. (Though that shouldn’t make them homeless.)
  3. She really does have crippling social anxiety, and it wouldn’t matter how bad things are, there really is no way for her to overcome the pain caused by having to interact with lots of strangers in a professional capacity. It is literally incapacitating.

I’m not sure which it is, but I suspect it’s two or three, both of which present problems. Also, if this were the only person who claimed to be unable to do necessary and important things because of psychological issues then it wouldn’t be worth mentioning, but there are millions of people who receive disability benefits because of mental issues which render them incapable of working, and this number doesn’t even include people like my friend’s wife. Once again we have the same core issue. Under the hygiene hypothesis we reduced the number of harmful antigens, but that made some people less physically healthy rather than more. In this example we have reduced the amount of harmful trauma, but this has made some people less mentally healthy rather than more. To repeat Brown’s point:

We are…The most in debt, obese, addicted, and medicated adult cohort in history.

The best example of all for this idea comes from the book Tribe, by Sebastian Junger. Which I discussed in a previous post. Speaking about the reaction of Londoners during the Blitz he said:

On and on the horror [of the Blitz] went, people dying in their homes or neighborhoods while doing the most mundane things. Not only did these experiences fail to produce mass hysteria, they didn’t even trigger much individual psychosis. Before the war, projections for psychiatric breakdown ran as high as four million people, but as the Blitz progressed, psychiatric hospitals around the country saw admissions go down…Psychiatrists watched in puzzlement as long-standing patients saw their symptoms subside during the period of intense air raids.

He then goes on to talk about the positive effects of war on mental health in general, including decreases in depression, suicide and even frequency of epileptic seizures. What might be considered an environment of poor mental hygiene produced improved mental health.

Interestingly enough, my dad recently read Tribe, and his conclusion was that despite being a very interesting book, that it wasn’t exactly scientific. I agree, and most of what I’ve written here hasn’t been especially scientific either, but I think there is something to this. That the negative second order effects of removing historical stress is an area which needs a lot more study. There is some stuff out there, for example a study claiming that growing up in an urban environment without pets increases vulnerability to mental illness. But so far whenever I hear people talk about the increased rate of modern mental illness as Brown does, their solution is always to reduce stress. In Brown’s case it’s to reduce the stress of shame (and maybe replace it with the positive stress of guilt? I’m not sure, but in any case more guilt is definitely not her focus.) Which is not to say it’s easy to identify and introduce positive stress. People with severe allergies have been known to infect themselves with hookworms. (Which worked by the way.) I’m not sure what the mental health equivalent of that is.

Whatever your feelings on the above. Humans are antifragile. We have survived thousands if not millions of years in environments of extreme stress and trauma, and yet now, it’s clear that less and less objective trauma is producing greater and greater reactions. And at some point we’re going to need to figure out why that is.

I’m taking next week off because I’ll be at Gary Con. But feel free to check out previous posts, for example the post I did on Tribe. And while you’re looking over the vastness of my writing, consider donating.