Angst: Anxiety & Depression Evolved from Primal Altruistic Instincts
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Transcript of Angst: Anxiety & Depression Evolved from Primal Altruistic Instincts
The Origin of Angst:How Anxiety and Depression Evolved From Ancient Herd Instincts –And Became Painful to So Many of Us
Jeffrey P. Kahn, M.D.Weill-Cornell Medical CollegeNew York, NY
UCLA Psychiatry Grand RoundsFebruary 2015
VIDEO LINK: psychiatrygrandrounds.com/GR15/JKahn.html
Jeffrey P. Kahn, M.D.
Disclosures:Author:
“Angst: Origins of Anxiety and Depression”
Oxford University Press
No other disclosures
Why Is There Angst?
Anxiety/Depression Must Have a Reason
A Theory on The Origin of Angst
Five specific syndromes reflect five corresponding social instincts - that try to coax us back to more herd-like behaviors
Our Anxiety and Depressive Disorders Are Modern Expressions of Ancient Herd Instincts
Simplistic nutshell: five core anxiety and depressive subtypes emerge when our rational and civilized behavior arouses our sociobiological instincts
Humans Wonder - and Wander
Humans Think Like This, Not Cows
Sheep Can Recognize Humans
And When We Wander From the Herd…
…Social Instincts Coax Us Back
Lions and Tigers and Bears are Not Why:Angst is the Modern Echo of
Evolved Social Instincts
Primeval Lions Evoked Fear - Not Angst
Most Important to People is: Other People Even Thoreau
The Central Social Core of Human Existence: Tribal/Herd Behavior Instincts
Social Emotion
A Social Focus for Evolution
Evolutionary Selection
Survival of the Fit Individual The Fittest Individuals Pass On Their Own DNA
Survival of the Socially Fit Herd The Fittest Social Behaviors Pass On Group DNA
Sterile Worker Bees Protect Species DNA
A Brave and Childless Mouse Protects Family DNA
Altruism!
Natural Selection: 2 Complementary Processes
Evolutionary PsychiatryIs Not A Brand New Idea
DarwinExpression of Emotions in Man and Animals
FreudA Phylogenetic Fantasy
Hyperaggressive “Ice Age Man”Das Unbehagen in der Kultur
Civilization and Its Discontents“The Discomfort in Culture”
JungCollective Unconscious
Many Others
Evolutionary Psychiatry:A Newer View of Psychopathology
DSM
Validated and Specific Psychiatric Diagnoses
But Some Diagnoses May Be Overly Broad
Major Depressive Disorder
Generalized Anxiety Disorder
Bipolar II Disorder
Five Specific Syndrome Subtypes
Panic AnxietySocial AnxietyOCDAtypical DepressionMelancholic Depression
Evolutionary Psychiatry:A Novel Sociobiological Synthesis
These Five Core Syndrome Subtypes Are Our AngstEach One Matches a Specific Social Instinct
Instinct Matches Syndromal Core Cognitions
Corresponding Behaviors Even in Us Civilized Types
Ethology and Animal Behavior
Specific Angsts from Specific Aroused Instincts
Each Syndrome Includes Related Syndromes
Humans Have Further Evolved These Instincts Intensification
Counter-Instinctive Adaptation
For Each Syndromal Instinct:Real Scientific Support
Science (More Than 600 References)Genetics and Epigenetics
Social Psychology
Animal Ethology
Psychopharmacology
Neurosciences
Clinical, Biological, Workplace Psychiatry
#1: Panic Anxiety: Stay Near Home Social Purpose:
Kept us close enough to home and group that we could safely find our way back.
An alarm to warn of geographic or emotional distance
Counterinstinctive BehaviorExample: Challenging Fear of Flying
Motto: “Catastrophes await if you can’t find your way home.”
Animals: Infant Separation Anxiety
Don’t Stray Far From Family, Home or Safety:Panic Anxiety
#2: Social Anxiety: Social Hierarchy Social Purpose:
Kept us in line in tribal social hierarchies to keep the peace at home.
Shy embarrassment from gratifying attention
Counter-Instinctive CopingExample: Performers Challenging Their Fears
Motto: “Shame and embarrassment come from not
knowing your primeval rank.”
Animals: Dominance Hierarchy – Alpha Dogs & Baboons
Follow the Leader of the Pack:Social Anxiety
“Too Many Cooks Spoil the Broth” – Old English Proverb
#3: OCD – Nesting Behavior Social Purpose:
Impels the work needed for groups to live together safely.
Motto: “Clean, arrange, save and behave for a sure and tidy
nest.”
The Four OCD Factors by Factor Analyses
Para-Instinctive CopingExample: Numbers and Technical Work
Animals: Nesting (and Grooming)
Clean, Arrange, Save, Behave
#4: Atypical Depression: Social Harmony Social Purpose:
Kept us well-enough behaved for a cooperative society.
Rejection Sensitivity Leads To More Polite Behavior
Counter-Instinctive Coping Example: Detached Workaholism to Succeed and Remain
Motto: “Behave yourself to avoid rejection, remorse and exile.”
Animals: Canine Apologies
Winter Hibernation Earlier Evolutionary Instinct, With Similar Symptoms
Go Along to Get Along:Atypical Depression
“Nature, when she formed man for society, endowed him with an original desire to please, and an original aversion to offend his brethren.” - Adam Smith
#5: Melancholic Depression: Preserving Herd Resources
Social Purpose: Death kept us from using scarce resources when we
no longer felt useful to the herd.
Eskimo Ice Floe Myth
Counter-Instinctive Coping Example: Counter Fatalism with Reason
Motto: “Take one for the team if you are too old or too ill.”
Animals: “Illness Behavior”
Salmon, Mice - and the Human DST
Apes and Dogs
Feeling So Useless You Could Die:Melancholic Depression
“How do we, humans know when it is time to move on? As with the migrant birds, so surely with us, there is a voice within if only we would listen to it, that tells us certainly when to go forth into the unknown.”
- Elisabeth Kubler-Ross
#6: Consciousness: Social Awareness
Social Purpose: Keep Us Responsive To Our Companions And Environment.
Allows Counter-instinctive And Repurposed Behavior
Moderates Ancient Instinctive Fears Except When Diminished by “Hypofrontality”
Motto: “Thoughtful Understanding Leads To Better Solutions.”
Animals: Dolphins, Apes, Crows And Dogs Have Some
But Human Consciousness They Have Not!
Positive Psychotic Symptoms Not Clearly Known In Animals
Consciousness Lost & Instinct Run Amok:Schizophrenia and Psychosis
“The very essence of instinct is that it is followed independently of reason.”
- Charles Darwin
Psychosis/Schizophrenia: Syndromes
Five Syndromes: Five Psychotic Subtypes
Aroused Instincts Override ReasonHypofrontality
The Missing Think
Decreased Conscious Mediation
Dopamine
The Provocative Power of Appetite
Increased Instinctive Arousal
Five Human Syndromes:Instinct Becomes Psychotic Perception
Panic Anxiety Classical Paranoid Schizophrenia: Alone against predators
Social Anxiety Paranoid Delusional Disorder: Authorities will punish you
OCD Schizo-Obsessive: Catastrophe from ignoring the nest
Atypical Depression Mania: From social harmony to saving the world
Melancholic Depression Psychotic Depression: The purposeless must die, rot away
Happy in the Herd:Instinctive Herds & Primeval Ignorance
“The security of Society lies in custom and unconscious instinct, and the basis of the stability of Society, as a healthy organism, is the complete absence of any intelligence amongst its members.”- Oscar Wilde
Assembling the Herd
From Bacteria to Herd to Homo sapiens
The Same Six Instincts Everywhere (Maybe not Melancholia)
Boids: Computer simulation of bird flocks
The Big Five Personality Traits (OCEAN)
All I Really Need to Know I Learned in Kindergarten
Varieties of Moral Experience: Political Herds
Instincts & Specialized Social Group Roles
Climbing To Civilization:The Rise of Reason & the Ascent of Angst
“It is impossible to overlook the extent to which civilization is built upon a renunciation of instinct.” - Sigmund Freud
Cogito Ergo Vincere Instinctu:Quelling Angst & Rethinking Herds
Beer and Civilization Consciousness and Everyman
The Origin of Psychopharmacology and Beer
Alcohol Free Societies Today
The Deliberate Herd A Higher Authority
Government
Civilization and Societal Advance Counter-Instinctive Coping
Consciousness, Teams and Technology
Illness and Instinct: Consciousness Has
Consequences
“Man is the only creature that refuses to be what he is.”
- Albert Camus
Mere Civilized ConsciousnessDoes Not Blissfulness Buy
Triggered Psychiatric Syndromes Coax us Back to the Herd
Stigma
Suicide
Alcohol and Substance Abuse
Crime
Heart Diseases “Stress” of Counter-instinctive Behavior
Free to Choose:How to Balance Your Reason & Instinct
“Nothing in biology makes sense, except in the light of evolution”- Theodosius Dobzhansky
“The final mystery is oneself.”- Oscar Wilde
Who Are You?
Consciousness or Biology?
Endure Suffering or Seek Succorance? You’ve Gotta Ask Yourself One Question:
Do You Feel Yucky? Do Ya?
Unexpected Risks of Treatment The Helmet Effect
Shiny Happy People?
The Vital Importance of Psychotherapy
Where Are We Headed Now?
Are We Still In the Same Place?
“The past is never dead. It’s not even past.”
- William Faulkner
To a greater extent than we have imagined, we may still live today in an emotional world designed on that ancient African savannah.
Angst: Origins of Anxiety and DepressionOxford University Press
For Book Reviews:Facebook.com/Evolutionary.Psychopathology
Jeffrey P. Kahn, M.D.Weill-Cornell Medical College