KPAO by Dave Cortright

It’s not the placebo effect, it’s the social connection effect

Modern medicine has only been around for a brief instant in the history of humanity. Penicillin isn't even 100 years old. And yet somehow we've been able to survive and even thrive for the vast majority of our existence. How is that possible?

 

Our bodies naturally have systems in place to keep us healthy and free from the common modern ailments: heart disease, diabetes, cancer, dementia... The further we stray from our EEA way of living, the less effective these systems are at keeping us healthy. Since we are social creatures, our genes select for hosts that do the best job at being social. I believe that the reason shamans and medicine men (and the placebo effect for that matter) work is because our bodies are positively responding to the validation of a respected member of our social group reaching out to us, connecting with us, and essentially saying: “You are an important and valued member of our social group. We want you to get better so you will stick around and continue to be part of the group.” And that validation triggers all of those defense and repair systems to kick into high gear.

 

Social cohesion around a shared story is more important than truth

One of the most profound results in all of social psychology is that of Solomon Asch’s conformity research. In a group of 8, if the other 7 members of the group all coalesce around an answer that is wrong, the 8th person will conform to the group consensus on at least one occasion 75% of the time. And perhaps more importantly, these people often created stories that made them believe the answer to be true.

It is such a common pattern throughout history and even currently in society that it's actually shocking we don’t talk more about it. The Elephant in the Brain book covers this pretty well, in addition to the You Are Not So Smart blog (and associated books and podcast).

Here are some examples of the world fighting against the actual truth because the lie had been so firmly entrenched for so long:

Heliocentrism: Despite the fact that the earth revolves around the sun, Galileo found staunch opposition not only from the religious, but also from fellow scientists such as Tycho Brahe. “Pope Paul V instructed Cardinal Bellarmine… to order [Galileo] to abandon the opinion that heliocentrism was physically true.”

Adult neurogenesis: [The dogma for the longest time was that] the adult brain doesn’t make new neurons. This is the basic premise of all the miserable, untreatable neurological diseases out there. And starting in the 60s, there was a one lone prophet named Joe Altman whose career was basically ruined because he was about 30 years ahead of the curve. And then in the late 80s, early 90s, some technique got a lot more sensitive and was able to show adult neurogenesis in the brain like crazy. —Robert Sapolsky on the Freakonomics podcast

Flat Earth: most cultures believed the earth to be flat. The first record of a spherical earth hypothesis was by Pythagoras in the 6th century BC. The truth spread slowly, and even China didn't subscribe to a spherical earth until the 17th century. And yes, even today there are groups of people who believe the earth is flat.

Cargo Cults of the South Pacific: primitive tribes in the South Pacific were introduced to modern civilization by seeing runways being built and airplanes delivering cargo in support of the war. They believed if they built their own runways (and other aviation-related accoutrements), the gods would send the planes to them loaded with cargo (mana from heaven).

Religion: This is the big one. And actually the cargo cults previously mentioned are just a modern instance of religion. Stories are interpreted, told, and retold to bond the followers around a particular way of thinking and living life.

---

This all makes perfect sense when viewed from the perspective of what maximized our ancestors chances of survival and reproduction. Cohesive bands of humans were much more likely to withstand adversity than individuals or even smaller groups. Getting to a shared story on the way the world worked—regardless of how accurate it was—created a stronger sense of community which would work together for the common good.

Razors in the wild

I’m a big fan of the Principle of Parsimony, otherwise known as Occam’s Razor. A razor is simply a logical concept that eliminates unlikely explanations for a particular conjecture. Here are a couple that I find gratifying.

The Holy Grail is really the cup of a carpenter:

 

Deducing the location of jewels hidden in a large, wooden house (from Tales of The Thinking Machine, The Mystery of the Flaming Phantom)

“The man who hid these jewels hid them only temporarily, or at least that was his purpose,” said The Thinking Machine, irritably. “Naturally he would not hide them in the woodwork of the house, because that might burn; he did not bury them in the cellar, because that has been carefully searched. Now, in that house there is nothing except woodwork and chimneys above the cellar. Yet he hid them in the house, proven by the fact that the man he killed was killed in the house, and that the outside ground, covered with snow, showed two sets of tracks into the house and none out. Therefore he did hide them in the cellar. Where? In the stonework. There was no other place.

“Naturally he would not hide them on a level with the eye, because the spot where he took out and replaced a stone would be apparent if a close search were made. He would, therefore, place them either above or below the eye level. He placed them above. A large loose stone in the chimney was taken out and there was the box with these things.”

Physical pain and emotional pain are both useful survival tools

I previously blogged about how there are no “bad” emotions, and in fact all emotions exist for a reason (otherwise natural selection would have weeded them out long ago).

The common pitfall we have is we naïvely want to minimize pain and maximize pleasure (or contentment). So when an emotion that makes us feel bad comes up, we do all sorts of convoluted tricks to try to avoid it (denial, mapping it to another emotion like anger or sadness, distraction…). But of course that doesn't change the truth that the emotion came up, and it did so for a reason.

Physical pain works the same way. If we lean against a hot stove, we experience pain and—while it is a negative feeling—it is overall a good thing. It minimizes harm to our bodies. It would be misguided to treat physical pain the same way we typically treat emotional pain. Pain is there for a reason. It is important information about how you are relating with the rest of the world. It's time we started listening and acting accordingly.

Human society today is like an industrial chicken factory (CAFO)

Humans were designed to live in bands of 30–45 members. Now we live in a world where you can come into contact with hundreds or even thousands of people every day, and orders of magnitude more if you count virtual interactions. Our brains simply aren't designed to manage a network of relationships that complex, as Robin Dunbar has shown.

While pondering this recently, I made the connection with how we mass-produce chicken meat. There are huge buildings filled with up to 20–30,000 chickens. Of course this is much larger than the number of birds that would naturally live in close proximity, and it screws up their pecking order. To keep the chickens from self-harm (pulling out their own feathers) or injuring others, they cut off most of their beaks when they are chicks.

Cram too many humans into close proximity without the proper tools to healthily navigate and manage such a large network and you wind up with similar problems—mental health, self harm, and harming others.

Live Every Day as If You Didn't Know How Many You Had Left

I understand the sentiment behind the adage “Live every day as if it were your last.” It’s a way of saying be more present and enjoy the moment now. Don’t delay all of your gratification.

Others have already pointed out some of the flaws in this reasoning. The primary being a very real possibility of focusing on short-term, narcissistic and hedonistic gains. It means an end to the iterated prisoner’s dilemma. The primary check and balance in any system of cooperation is the possibility of future retaliation. When retaliation is a real possibility, then cooperation (with occasional retaliation if required) is the best strategy. If the relationship has a known finite end, it removes that governor and makes it much more likely one side or the other will defect.

Yes we are all going to die, but we don't know when. And not knowing when is a powerful force in keeping us all on track and cooperating.

The Bowlby Conjecture—how we humans were designed to thrive and why we struggle in modern civilization

John Bowlby developed the concept of the environment of evolutionary adaptedness (EEA). It is the set of environmental factors that constrained and directed the evolution of a particular species. For example one aspect of the the EEA for polar bears is a cold environment of snow and ice. That led to polar bears having thicker fur and fat for insulation, and a white coat for blending in with their surroundings to better stalk their prey.

We humans had our own EEA: the area in South and East Africa during the Pleistocene epoch. The environment wasn’t just the landscape, climate, and biosphere. It also included the social structure of pre-human primates and humans. Our ancestors lived in nomadic hunter/gatherer bands of 30–45 individuals, comprising a multi-generational extended family primarily. They spent the vast majority of their time outside in nature, moving their bodies (walking, running, grasping, squatting… and using their hands for fine motor activities). They ate a diet of both raw and cooked whole foods, primarily fruits, vegetables, nuts, roots, and some meat. They had shared stories and experiences that they told and retold which helped maintain group cohesion.

Genetically modern humans appeared at the latest 50,000 years ago. This was when our DNA—which is the source code to Human OS version 1—had its last major update (which was very likely the ability to speak). The environment that our modern ancestors lived in between 50k–12k years ago was the one for which our DNA has been optimized.

From the agricultural revolution through the industrial revolution into the information revolution today, slowly but surely some of our ancestors started making decisions to live in ways that they felt were more convenient. But that whole time our genes stayed essentially the same. There were some minor variants—skin, hair and eyes to be better suited to different climates, lactose tolerance, and even sickle cell anemia (to protect against malaria). But on the whole the core Human OS was—and is—still running, optimized for a much different environment than we have today.

In modern civilization today (at least for the people who are likely to be reading this), most of us spend a large portion of our days inside, sedentary, staring at screens, eating processed foods, and spending far more time alone more often than any point in history. We now have a society that is orders of magnitude bigger than the 150 or so individual relationships Dunbar determined we were optimized to have. We have created a world in which it is possible to satisfy our Physiological and Safely needs (the bottom two levels of Maslow’s Hierarchy) without needing to truly invest in Love and Belonging. Anyone without that foundation is also left deficient on the two levels above (Esteem and Self-Actualization). This has led to increasing rates of depression, anxiety and suicide, which were already high to begin with.

I’m not saying we need to go back to bands of hunter/gatherers in order to have healthy and fulfilling lives. But we do need to look at the core daily aspects of that lifestyle and make a point of incorporating them into the foundations of our lives. Yes diet, yes exercise, yes being out in nature. But of critical importance are good relationships and social connections. The closer we can live our lives adhering to those aspects of our ancestors, the happier and healthier we will be.

---

There many diverse data sources that support the consilience of this conjecture:

• John Bowlby’s Environment of Evolutionary Adaptedness
• The Harvard Study on Adult Development (Grant and Glueck studies: “The only thing that really matters in life are your relationships to other people.” —Triumphs of Experience by George E. Vaillant)
• The Blue Zones (including The Blue Zones of Happiness)
• The Roseto Effect
• Dunbar’s Number (and perhaps more importantly, the levels of intimacy in relationships)
• Maslow’s hierarchy of needs
• The 5 Regrets of the Dying
• Rat Park experiment by Bruce Alexander
• Everything You Think You Know About Addiction is Wrong by Johann Hari
• This Could Be Why You Are Depressed or Anxious by Johann Hari
• Murray and Peacock, 1996 (from The 100 Simple Secrets of Happy People by David Niven)
• the work of Seligman and Diener
• The Surprising Science of Happiness by Dan Gilbert
• The Mystery of Happiness ABC News special, 1996
• Habits of a Happy Brain by Loretta Graziano Breuning
• The Selfish Gene, et al. by Richard Dawkins
• Ishmael, et al. by Daniel Quinn
• The Awakened Ape by Jevan Pradas
• The Social Conquest of Earth by Edward O. Wilson
• The Expression of the Emotions  in Man and Animals by Charles Darwin
• The Mask You Live In
• Co-housing (good intro videos here and here)
• The Hygiene Hypothesis
• Exposure to sunlight helps prevent myopia
• Parasites help regulate our immune system
• The biomechanics of squatting while defecating
• The biomechanics of standing, walking and sitting

I would appreciate any other references that either support or refute this conjecture. 🙏🏼

---

Tangential but also key to this conjecture is the fact that we humans have excellent deception skills. In fact we are so good at it, the only way we can really deceive others is to also deceive ourselves. Why else would we—individually and as a collective—continue to make choices that are not ultimately in our long-term best interest?

• The Elephant in the Brain by Kevin Simler and Robin Hanson
• You Are Not So Smart by David McRaney
• Adam Ruins Everything, a TV show debunking common misconceptions

Connection to a community outweighs technology and modern conveniences—the Amish on happiness

I remember watching The Mystery of Happiness hosted by John Stossel with my dad back in the '90s (it first aired April 1996). It's well done—there’s a lot of great data in there and it holds up to the test of time surprisingly well.

One segment that is particularly insightful is that of the Amish.

When the Amish took the happiness test, all rated themselves as happy or extremely happy. Some admitted to rating themselves lower because it's not polite to brag. The most important quote from the Amish woman's perspective: “You have lots of cousins—100, maybe 150—that will always be there to take care of you if you have a need. It’s a security we probably take for granted.”

The Amish shun most innovations that came about since the industrial revolution. But they don’t ignore the fact that they exist. Amish adolescents are allowed a period of rumspringa where they can spend time in modern society and see how it works for them. And after sampling the lifestyles of both, still 85–90% of them choose to come back to their Amish community and live without all of those modern conveniences. Such is the overwhelming draw of a solid sense of love and belonging (level 3 on the Maslow Hierarchy of Needs).

 

Ed Diener—one of the preëminent psychologists studying happiness—found the Amish to be one of the happiest populations out there, on par with that of the wealthiest people in America. And this is despite their spartan lifestyle and lack of technology or modern conveniences.

The Bowlby Conjecture—how we were designed to live and thrive

As I’ve been talking to people about my idea, I’ve realized that the “razor” concept is too obtuse to be useful. There is a razor aspect to the concept—anything that wasn’t a part of the environment of our ancient ancestors is by and large unnecessary for overall happiness and well-being. However there are exceptions such as antibiotics and other aspects of modern medicine.

But also, it’s not really a black-or-white, true-or-false binary that cuts off the unnecessary from the essential. It’s a gradual spectrum where we can choose to trade comfort or convenience for things that make us proportionally less healthy. And there are also multiple factors at play in every decision; it’s difficult to separate out the purely good from the purely bad.

So my current favorite title is “The Bowlby Conjecture”. Simply stated, because our genes were selected to work optimally in the environment in which our Pleistocene ancestors lived, the closer we live our lives emulating the core aspects of that lifestyle, the more we will thrive. Conversely, the further our lifestyle drifts from those core aspects, the less healthy and happy we will be.

Those core aspects: living in a tight-knit social tribe, moving our bodies throughout the day (especially walking, running, and fine eye-hand motor skills), eating a diet of fresh, whole foods, near-constant exposure to nature, sunlight and the elements. Relying as much (if not more) on your senses and being in the present moment as on your thinking brain.

NatGeo promotes “The Evolution Diet”, which aligns with Bowlby’s Razor

Just came across this article in Nat Geo (Feb 2013) on the diets of our ancestors. One key point missing in the article is the importance of cooking in our ancestors’ diets. Cooking food helps break it down before it enters the body, thereby reducing the amount of work the digestive system needs to do.

And while some populations survive on a meat-heavy diet, most eat primarily a plant-based diet supplemented by whatever meat they can acquire.

But regardless of the amount of meat in your diet, the real key is that foods be reasonably varied and unprocessed. The article says, “you are what your ancestors ate”, which I would rephrase more accurately, your genes were optimized to thrive on the diet of your ancestors. The further from that we stray, the more it will negatively impact our health.