Science and Pseudoscience of Mental Health Podcast: Episode 2
In 1955, Erich Fromm published a book called The Sane Society. The basic premise is that cultures that support our existential needs for love, community, autonomy, creative expression, purpose, meaning, and communion with nature, enable us to become fully actualized, sane human, beings. Cultures that fail to do so, engender mental illness. Darcia Narvaez,1 a Professor of Psychology at the University of Notre Dame, has taken up the mantle of Fromm’s quest to identify and promote sane cultural practices that foster mental health. A prolific multidisciplinary scholar, her recent books include Neurobiology and the Development of Human Morality: Evolution, Culture and Wisdom (2014) and Basic Needs, Wellbeing and Morality: Fulfilling Human Potential (2018).
Narvaez’ research is urgently needed because Western culture — which is being exported and adopted globally — breeds societies that are anything but sane. Fromm wrote The Sane Society in the aftermath of World War II as an antidote to the nightmarish consequences of extreme nationalism and the rhetoric of hate, and yet today we are witnessing a resurgence of these toxic trends in the US and across Europe. Our planet is at a tipping point of ecological sustainability placing our very survival as a species at risk while the EPA’s environmental policies which were weak to begin with are being further eroded by our current government. The time we spend engaged with our devices far outstrips unmediated time with each other or in nature, but tech titans like Amazon, Google and Facebook work tirelessly to increase our dependence on and addiction to their products. These cultural sequalae are directly eroding our mental and physical health. Symptoms of depression and anxiety are ubiquitous. Chronic illnesses like type II diabetes, and a host of autoimmune disorders — formerly diseases of middle and old age — are commonplace at increasingly younger ages, and the incidence of childhood illnesses like autism and childhood cancers is rising exponentially.
The postmodern zeitgeist of the past few decades encourages us to believe that we can endlessly reinvent ourselves untethered to our human biology and our ecosystem, and it is setting the stage for a posthuman future. Ray Kurzweil, Google’s chief engineer, has been vigorously researching and promoting his vision of the next stage of evolution which he calls “the singularity” in which we will merge our consciousness with our technologies, thus liberating ourselves from our frail bodies, limited intellects and the vicissitudes of nature, and effectively, cease to be human. (Failing that, when we have thoroughly trashed our planet, we’ll leave it behind and colonize Mars.) There is a growing consensus among thought leaders in the technology industry, which is echoed in popular sentiment, that an AI (artificial intelligence) future is not only inevitable but preferable to an exclusively human future. How have we lost the collective desire to cherish and protect our species and our planet? This raises the question: is this not the hallmark of insanity?
The Sane Society and the Evolved Human Nest
Narvaez points out that each species including our own has an “evolved nest” — a set of environmental conditions that is necessary to optimize its unique maturational imperatives. The evolved human nest should, therefore, possess the qualities of Fromm’s sane society, enabling us to develop and live according to the fullness of our human potential. Utilizing the sciences of anthropology, psychology and neurobiology, one of Narvaez’ central projects has been to identify and describe the evolved human nest, and the characteristics of people who are raised in and live their lives accordingly. She reminds us that for 99% of human history, all of our ancestors lived as small band hunter-gatherers (SBHG).2 Farming was discovered only 10,000 years ago and the industrial age came about 300 years ago, a mere second in the sweep of human history. And so, she makes the compelling argument that to understand how we evolved to live, and who we evolved to become, a close study of the shared qualities of SBHG groups spanning hundreds of thousands of years is the ideal place to start. But first, we need to understand a glitch in our evolutionary wiring.
An Evolutionary Compromise: Born Too Soon
As anthropologist Meredith Small explains in her book Our Babies, Ourselves, four million years ago, our predecessors began to walk on two legs, setting the stage for a critically important human advantage: the capacity to use our hands for creative innovation. Walking on two legs obligated an anatomical restructuring of the pelvis resulting in a narrower birth canal. A narrower birth canal was initially not a problem until around one and a half million years ago, when, as neurologist Frank Wilson, author of The Hand points out, our clever, inventive hands needed increasingly larger brains to power them. The challenge of freakishly large-brained primates descending treacherously narrow birth canals might have led to our extinction if not for the aforementioned evolutionary compromise; human newborns are born in a state of extreme neurological immaturity (75% of brain maturation occurs after birth) with the accompanying adaptation that caregivers (for the most part) acquired the will to care for our uniquely fragile infants. Several key features of the evolved human nest are determined by the kinds of relationships and environments our premature infants require. As we will see, when we fail to protect healthy brain development in the early months and years, the implications for who we become and what kinds of societies we create are profound.
Being born too soon requires that in the first weeks and months of life caregivers recreate, as much as possible, the protective prenatal environment. A calm and natural birth without unnecessary drugs or surgical interventions facilitates an immediate soothing connection between mothers and infants and quiets newborns’ acute stress response, following the inevitable shock of being expelled from the relative Eden of the womb. A natural vaginal birth also optimizes the seeding of the microbiome, the internal ecosystem of microbes that plays such a critical role in human health.3 Breastmilk provides infants not only the ideal macro and micronutrients, but also their mothers’ antibodies, conferring the benefits of a mature immune system, and it is another mechanism through which mothers share their microbiome. Continuous sensory engagement with a loving village of caregivers — as much as possible in natural settings — catalyzes a cascade of essential epigenetic triggers that ensure optimal maturation of brain and body. As psychologist James McKenna’s innovative mother-infant sleep research reveals, continuous skin to skin contact helps to regulate a host of homeostatic processes — including internal temperature, respiration, heart rate, and brain wave patterns — that infants are not yet mature enough to control. These very conditions are present in all SBHG groups and form the core elements of the evolved human nest.
Small Band Hunter-Gatherers, the Evolved Human Nest and Self-Actualization
According to Narvaez, children in SBHG groups are regarded from birth as autonomous beings, and following the protected stage of infancy, they are given the freedom to structure their own lives, with adults serving primarily as role models and wise elders. Children spend much of their time playing in multi-age groups, embedded in the natural environment of their local landscape. Their play is cooperative, imaginative, and skill building. Targeted aggression and bullying are actively discouraged through gentle teasing and when necessary by temporarily ostracizing the aggressor. Over time, they develop the capacities necessary to be valued members of the group, and their work retains a playful, unregimented rhythm. Paradoxically, SBHG children acquire a powerful sense of agency while at the same time their sense of self is deeply rooted in their relationships with the entirety of their community and, indeed, with their natural environment. As such, they don’t assert their autonomy in ways that burden other group members or harm their natural environment any more than they would harm themselves. This contrasts significantly with the sense of self that is encouraged in Western cultures which emphasizes competition as opposed to cooperation with others, and in which nature is viewed as a commodity to be mined and managed rather than a living part of ourselves.
Natural birth, extended breastfeeding, loving attunement on the part of a village of caregivers, continuous sensory contact with caregivers and nature throughout infancy, deep respect for children’s autonomy, a concept of self-in-relation, free play with multi-age peers, and reverence for nature — in other words, the universal conditions of SBHG life — are, according to Narvaez, the key ingredients of the evolved human nest. Her overview of anthropological research reveals that adults who develop under these conditions tend to be calm, highly intelligent, generous, communal, egalitarian, playful, creative, artistic (song and dance and other forms of artistic expression are ubiquitous) and resilient. Patriarchy, misogyny, social hierarchy, and material wealth are unfamiliar concepts. Wise elders are respected but they do not have greater power or possessions than anyone else in the group. And so, the evolved nest begets the qualities that align with Fromm’s notion of a fully actualized human being.
The infant-care provided by SBHG parents dovetails in many ways with what has come to be known as “attachment parenting,” culled from more than a half-century of research inspired by the groundbreaking work of the mid 20th century British psychiatrist John Bowlby. Bowlby awakened Western parents to the vital importance of loving, attuned parenting with ongoing sensory engagement for healthy psychological development, and the enduring emotional trauma that ensues when infants are denied this mode of care. With the advent of technologies that enable observation of the living brain (as opposed to post-mortem studies), neuropsychologist Allan Schore and his colleagues brought attachment research into the 21st century by revealing the neurological imprint that underlies the psychological harms that Bowlby and his disciples observed in the infants and children they studied. Schore discovered that the right hemisphere of the brain plays a dominant role in the formation of attachment relationships and that its maturation is at significant risk in conditions of suboptimal infant-care practices.
In lockstep with Schore’s work, pediatrician Jack Shonkoff, founding director of the Center on the Developing Child at Harvard University, has trained a lens on the CDC’s ongoing Adverse Childhood Events (ACEs) research which demonstrates the impact of discrete traumatic events and/or chronic stressors during infancy and early childhood on the capacity of the nervous and endocrinological systems to cope with stress effectively throughout life. The ability to manage stress is one of the key ingredients of mental health. While it is not hard to grasp that extreme forms of trauma such as physical abuse or abandonment have a lasting impact on psychological well-being, it is not apparent that any childcare practices or environments that do not meet the conditions of the evolved human nest are stressful and leave their mark on the brain and the psyche of the developing child.
Undercare in the U.S.
“Undercare,” a term coined by Narvaez, refers to normative, socially accepted childcare practices that do not meet the conditions of the evolved human nest. For example, it is normative for American mothers to have medicated hospital births with surgical interventions such as episiotomies and C-sections; to curtail breastfeeding after only days or weeks; to leave infants in detachable car seats and strollers for hours at a stretch; to “sleep train” them by leaving them to cry themselves to sleep; and to place them in daycare settings with unfamiliar caregivers who may have minimal training and limited investment in their care. In spite of the overwhelming evidence stemming from the research of Bowlby, Schore and Shonkoff that these practices cause enduring harm, they are nonetheless deemed safe and even actively encouraged by many OBGYNs, pediatricians, and parenting experts. To add to the confusion, a majority of infants appear to adapt seamlessly to these conditions. But while behaviorally, they may be symptom-free, and indeed cry less when left alone in their cribs at night after a bout of sleep training, inwardly, neurological, endocrinological and physiological processes are being damaged and dysregulated. The consequences of undercare tend to reveal themselves later in childhood in the form of chronic anxiety, depression, learning and behavioral challenges, and chronic illness.
To be fair, attachment research has catalyzed some positive changes. In contrast to the late 1950s and 1960s when Bowlby first began to publish his research, today, after giving birth, mothers in Western cultures typically room in with their infants, and children are rarely separated from parents during hospital stays for “hygienic” reasons. Several countries in Europe widely encourage natural childbirth and extended breastfeeding and they offer generous parental leave and heavily subsidized childcare. But here in the U.S., for the most part, public policies remain downright hostile to attachment parenting. For example, federally protected parental leave which falls under the umbrella of the Family and Medical Leave Act (FMLA) is limited to a mere 12 weeks of unpaid leave which many parents cannot afford to avail themselves of, and this paltry benefit only applies to individuals whose workplace employs 50 or more people. As a consequence, mothers are frequently forced to rush back to work when they are still actively recovering from childbirth, and to place their weeks old infants in daycare.
Daycare, in theory, is a viable and even desirable form of childcare. Narvaez stresses that in SBHG groups, virtually everyone in the community participates in infant-care; caregivers are not limited to biological kin, or to females. And mothers are not sequestered away but participate fully in all aspects of community life (although they may choose in the days and weeks following a birth to spend most of their time exclusively breastfeeding and resting with their newborns). The benefits of being known to, loved and supported by the entire community has a profound impact on children’s burgeoning sense of security, optimism, belonging and identity. This, Narvaez emphasizes, is a vastly superior model for the mental and physical health of both mother and infant than the stereotypical American version in which mothers are isolated in suburban homes or rushed back into the workforce prematurely. At its best, the daycare becomes a seamless and invaluable extension of the loving care provided by the nuclear family. But as developmental psychologist Laura Berk points out, high-quality daycares in the U.S. are the exception, not the rule, and tend to be prohibitively expensive. Daycares are rarely subsidized, poorly regulated and often staffed by minimum wage, overworked caregivers with limited training and challenging working conditions. This encourages revolving door staffing; employees often leave whenever a better paid and less stressful gig comes along.
And so, a common outcome is that desperately sleep-deprived mothers not yet recovered from childbirth rush back to work, with no private spaces to pump their breastmilk while their infants are placed in stress-inducing, substandard daycares where they are unlikely to receive the ongoing care their immature brains and bodies need, and where their undeveloped immune systems are forced to cope with a barrage of unfamiliar exposures, made all the more challenging because they are not receiving the protective antibodies and microbes from their mothers’ breastmilk. And so, attachment parenting becomes a luxury for those well-to-do and well-educated parents who have the means to take time off from work or to outsource the “village” of caregivers that are ubiquitous in SBHG groups.
Attachment Parenting: Rediscovering Primal Wisdom
It is intriguing that we are so alienated from human nature that we had to conduct decades of painstaking research to rediscover and to justify the rightness of such elemental practices as not leaving infants to cry. Attachment researchers have succeeded in translating what Narvaez refers to as the “Primal Wisdom” of our ancestors, into the language of empirical science, the only source of information that Western cultures trust. And yet, in spite of the wealth of research that demonstrates the relationship between attachment parenting and optimal neurological and psychological development, Western values that privilege acquisition and competition over care and community inform political and corporate agendas which stand firmly in the way of change. A robust medical and childcare industry convinces us to ignore the science. Women are routinely made to feel terrified of natural birth in spite of the excellent, indeed superior safety records of nurse-midwives; they are shamed when attempting to breastfeed in public spaces; they are rushed back to work because of weak or absent maternity leave policies; and they are forced to acclimate their infants to the regimentation of their work lives. In this alternate corporate universe, unhealthy practices are deemed healthy and advantageous — sleep training, early weaning, leaving infants to cry, the absence of skin to skin contact for hours at a stretch, limited time outdoors in natural settings. And healthy, protective practices are viewed as bizarre or downright life-threatening — unmedicated births, extended breastfeeding, wearing infants for much of the day, sleeping beside them to facilitate parenting throughout the night.
The influential developmental theorist and psychoanalyst Erik Erikson taught us that the transmission of values, beliefs and customs from one generation to the next — enculturation — occurs through informal and often unconscious lessons gleaned from our parents whose own worldviews are a microcosm of the wider culture. And so, our way of being in the world becomes part of the very fabric of our being, not readily influenced by formal lessons or logic. The research of Schore and Shonkoff reveals that enculturation is not only deeply imprinted onto our psyches at a tender age but also onto our brains. As discussed earlier, because we are born too soon, fully 75% of brain development occurs after birth. As such, how we’re parented — our culture in microcosm — has a profound impact on how our brains develop. We have evolved to need specific environmental triggers that are embedded in infants’ sensory connections to their caregivers and to nature, which switch on genes according to a carefully timed schedule and these genes then catalyze a complex choreography of brain maturation. These essential epigenetic triggers have been part of the universal human experience throughout most of human history when we were all small band hunter-gatherers, and they are still today in many cultures. In other words, they are part of the evolved human nest. It is only in advanced technological cultures that these stimuli go missing as we replace breast with bottle, bedsharing with cribs, slings with strollers, and living in nature with drywall boxes (to borrow a phrase from Zach Bush).
The right hemisphere of the brain matures rapidly during the last few months of gestation and the first two years of life before the left hemisphere “comes on line” because it plays a dominant role in forming empathic relationships. The early maturation of the right hemisphere enables newborns to enter the world neurologically primed to become loving and beloved members of their communities. In their groundbreaking 2014 Lancet article, environmental health experts Philip Landrigan and Phillipe Grandjean reported that, to date, 1,000 industrial chemicals4 have been identified as neurotoxicants (toxic to the brain). These chemicals cause the greatest harm at the lowest doses to the rapidly developing right hemisphere of the fetus and infant. Therefore, the right hemisphere is doubly at risk through the disappearance of vital epigenetic stimulants embedded in the human nest, and through pre and postnatal exposure to hundreds of neurotoxicants such as lead and mercury.
Right and Left Hemisphere Worldviews
Iain McGilchrist, author of the highly acclaimed book The Master and His Emissary: The Divided Brain and the Making of the Western World, persuasively demonstrates that in chicken and egg fashion, when cultural and environmental conditions undermine right hemisphere development, the ensuing neurological deficits alter the way we perceive the world in such a way that we are more likely to intensify the very conditions that created right hemisphere deficits in the first place. In other words, when we defile our nest, we undermine brain development in ways that encourage us to further erode our nest, which further undermines brain development and so on. The right hemisphere is widely (and problematically) associated with emotion and intuition while the left hemisphere is typically conceptualized as the center of logic and language. In our post-Cartesian world, it is assumed that the “rational” left hemisphere is more evolved and must reign in the more emotional/irrational right hemisphere. In fact, both anatomically and functionally, it is the right hemisphere that is designed to play a leading role, and the left hemisphere, while of critical importance, subserves the right hemisphere. McGilchrist is fond of saying that while “the right brain knows that it needs the left brain, the left brain doesn’t know what it doesn’t know.” In consequence, when the right hemisphere is not functioning at its best, the left hemisphere tends to dominate our consciousness with dire results.
McGilchrist emphasizes that the left and right hemispheres do not, in fact, differ in terms of what functions they perform, but rather in terms of how they direct our attention and shape our worldview. The unique ways in which the left and right hemispheres both contribute to language exemplifies this concept well. In McGilchrist’s words:
[T]he “music” of speech … coupled with other forms of nonverbal communication—constitutes the majority of what it is we communicate[.] … Denotative language is not necessary for I–thou communication. [T]he aspects of speech that enable us truly to understand the meaning of an utterance at a higher level—including intonation, irony, metaphor, and the meaning of an utterance in context— are … served by the right hemisphere. Denotative language becomes necessary when we have projects— when we need to communicate about a third party or about things that are not present at the time. It expands immeasurably our capacity for manipulation, what one might call “I–it” communication. It is not therefore necessary for communication in itself, but for a certain kind of communication.”5
The right hemisphere attends to the sweeping panorama of sensory experience, attunes us empathically to others, and is comfortable with novelty and uncertainty. The most evolved regions of the brain are the frontal lobes which give humans the unique ability to “stand back from the world,” as opposed to just being in the moment of our thoughts and feelings. Standing back from the world enables us to see the world as something we can use, or to feel even more deeply connected to it, to see others, to see nature as also having a self, as more like ourselves — to empathize more deeply. The right frontal lobe serves our capacity for deep empathy: It enables us to experience “awe, imagination, creativity, music, dance, poetry, art, love of nature, a moral sense, a sense of humor, the ability to change our minds.” The attention/worldview of the right hemisphere creates I-thou relationships, not only with fellow human beings but with all of nature.
The left hemisphere, according to McGilchrist, is designed to help us with basic tasks of survival, and as such it focuses narrowly on detail, breaking the world down into component parts and abstracting a mechanistic understanding of the world. It offers great clarity and power to manipulate that which is already known, decontextualized, explicit, disembodied, but ultimately lifeless. The left brain is relentlessly optimistic and immune to new ways of understanding acquired through direct experience because it refuses to consider that which does not fit with its pre-existing models. McGilchrist states that “the left hemisphere pays attention to the virtual world that it has created, which is self-consistent, but self-contained, ultimately disconnected from the other, making it powerful — but also curiously impotent, because it is ultimately able to operate only on and to know, itself.” The left hemisphere fosters I-it relationships; everyone and everything in nature is a resource to be mined.
While the right hemisphere enables us to love and to experience awe and wonder, it also attunes us to anguish, mourning and suffering. It is much easier, for example, to be a climate change denier if you choose to ignore right brain consciousness. It can be tempting to forgo joy in order to escape anguish by escaping into the left brain, with its highly effective defense mechanisms, and our postmodern world makes it increasingly easier to do so. Beginning in infancy, millions of children are already immersed in screen technologies, circumventing the messiness and unpredictability of the living world. There was a time when there were natural brakes on our capacity to escape from living in the moment, but technologies increasingly make it feasible to dwell in virtual worlds that place no limits on our flight from reality.
It is readily apparent that SBHG cultures map seamlessly onto a right hemisphere dominant worldview. By contrast, Western cultures — American culture, in particular — map onto a left-hemisphere-dominant worldview with its relentless optimism as we blindly ignore global warming even as it spells our own demise, and as we place more faith in an AI future than a human one. And still, there are hopeful signs. They are expressed in our cultural fascination in recent years with practices such as yoga and meditation, the growth of the organic food industry, and the rise in popularity of psychotherapies that emphasize mindfulness and ecopsychology, as well as integrative approaches to health, all of which tap into a right-brain-driven worldview. The explosion of research on the microbiome reminds us that we are deeply embedded in an ecosystem that lives within us and around us, without which we cannot survive. These trends reveal a hunger to recapture aspects of our humanity that we yearn to reconnect with. This reawakening of right-brain consciousness is essential because stepping back from the precipice requires that we tap into its imaginative capacities. It takes only the vision and the intention of a single generation to raise its young within the evolved human nest, in accordance with the primal wisdom of our ancestors and the brilliant science of Bowlby, Schore, Narvaez and McGilchrist, to reinvigorate an I-thou reverence for all of life.