How Mental Health Syndromes Arise From Social Change

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.

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.

Specifically, many researchers argue that syndromes as diverse as “schizophrenia,” hearing voices, and “ecological grief“ should be understood within broader historical and social contexts.

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:

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:

 

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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)