A recent chapter published in the book Perspectives for a New Social Theory of Sustainability explores a “systems theory” perspective on how mental health syndromes arise and evolve over time. The authors discuss how the emergence of syndromes is linked to changes in migration patterns, technology, social norms, medicine, economic inequality, and more. These syndromes range from the “rapidly mutant” to the “slow mimetic mutant.” They suggest that some syndromes can be viewed as “heralds” for societal changes on the horizon.
“We propose a model to explain the possible cybernetics of syndromes. We consider cultural tradition as well as the transformation processes that link the effects of migration to the process of globalization. We try to figure out how psychiatric syndromes are linked to social context and the ecosystem in which they are embedded,” explain the authors, led by Italian psychiatrist Paolo Cianconi.
“Syndromes indirectly highlight choices made when certain conditions spread into the social body. It is possible to see consequence expression in the psychopathology of the general population, especially among vulnerable groups.”
There is a growing movement in psychiatry and adjacent fields toward an ecological understanding of mental health as socially and economically based, rather than solely as arising within individual brains, as in the medical model.
In their chapter, the authors give a broad overview of how complex, nonlinear ecological and social systems can lead to new developments in psychopathological syndromes, as well as changes in existing ones. The authors begin by talking about “cultural syndromes” in relation to migration. Then they discuss how shifts in existing social and environmental systems can affect even those who “stay in place.”
The authors theorize that the human mind is always seeking stability and coherence, but changes in our ecosystems can present challenges to mental and emotional sustainability. This sustainability requires our ability to “avoid threats,” as well as gaps in power and lack of access to resources.
Discussing cultural syndromes, they argue that as individuals migrate from one culture to another, shifts can occur in the nature of pathological syndromes. They note that “new immigrants to Europe showed a low positive response, even to traditional therapy,” such that healing methods from the original culture may not be able to address the syndrome as it has evolved. There can be a “mutation” that occurs as people are exposed to different environments. Specific environmental factors that lead to difficulties that migrants face include racial discrimination, lack of belonging, language difficulties, job precarity, and more.
In terms of changes in existing contexts, the authors believe that traditional ways of understanding psychopathology can easily become confused by the complexity of social changes. Processes of industrialization and globalization, leading to our current “postmodern” technological era, can shift the ground beneath our feet:
“If it is the social territory that moves under our feet, like a sliding platform, the objective situation is that of being elsewhere, despite the fact that we have not moved geographically.”
These environmental shifts can lead to shifts in pathological syndromes, which the discipline of psychiatry, as well as individual therapists, may have difficulty recognizing. The authors list several issues as examples of this phenomenon, such as climate change syndromes, collapsing societies due to natural disasters, and social paranoia syndromes. They note that societies experiencing “rapid economic crises or decline” show higher rates of distress, suicide, alcohol abuse, and gambling.
The authors discuss PTSD as an example of a “rapidly mutant syndrome.” Vietnam veterans were faced not only with the violence of war, but also a cultural conflict with emerging pacifism as they returned home.
“Avenger shooter terrorists” are another rapidly mutant syndrome discussed, where individuals—”young adults, presently mostly males, intelligent, generally well-off, often exhibiting social problems, selective withdrawal, rarely sociable, and having little intimate life”—attempt to “take revenge” on a rapidly changing world from which they feel disenfranchised. The authors argue that this population may be a “counterinsurgency against globalization,” as some groups feel alienated and left out by rapid postmodern societal shifts.
Syndromes can develop at a slower rate as well, due to factors such as “poor access to resources,” “racism and oppression,” “the availability of new drugs,” “environmental unpredictability,” and more.
These “slow mimetic mutant syndromes” are often confused by psychiatrists and therapists with existing syndromes. The authors list “hysteria” and “possession” epidemics in the 19th century here, as well as the evolution of these syndromes into the bourgeois “borderline personality disorder” in the 1950s. Some symptoms stayed the same, while the overall syndrome changed shape significantly.
The authors note that all syndromes are dynamic and will undergo “shaping and smoothing,” according to how medical culture and other environmental forces interact with them.
Finally, they argue that syndromes can serve as a “herald” of unforeseen societal changes, like a canary in a coal mine. As our minds and cultures “absorb” changes in the environment, this will lead to both changes in existing syndromes as well as the violent eruption of new syndromes.
The authors conclude by suggesting the necessity of understanding broader world contexts if therapists want to understand psychological syndromes and symptoms:
“Syndromes are dynamic functions. Their symptoms are expressions of clear malfunctioning of the biological, cognitive, emotional, and social systems (the core), influenced by a context or cultural condition. When a social system (whether globalization, migration, or any other social crisis) changes, the dynamic balance needed for survival is compromised, which is evidenced in certain psychopathologic phenomenology.
Today’s therapists must have a solid grasp on the evolution of our world in order to study mutations that occur in communication. Biological entities often struggle to achieve homeostasis, even in desirable environments.”
Cianconi P., Tomasi F., Morello M., Janiri L. (2020). Toward an understanding of psychopathological syndromes related to social environments. In Nocenzi M. & Sannella A. (eds), Perspectives for a new social theory of sustainability. Springer: New York. (Link)