Book review: Angst: Origins of Anxiety and Depression by Jeffrey P. Kahn
Price: US$27.97, NZ$49.99
Hardcover: 304 pages
Publisher: Oxford University Press, USA (October 22, 2012)
I can see this book appealing to beer lovers. Or at least beer lovers with an interest in evolutionary science and psychology.
As the author tells it:
“Alcohol came along early on, and it may have been with us for as long as 100,000 years. The prevailing theory is that humans domesticated grain for food, and then discovered that stored grain can become beer. According to a more recent theory, we first domesticated grain for alcohol, and bread was only an afterthought. At a human archaeological site some 11,500 years old, there is evidence of a society that farmed, despite a diet that contained little grain (and our Neanderthal cousins were pretty much pure carnivores). All that hard work planting, harvesting and preparing grain makes far more sense for a cold one than for mere bread, especially if fruit and game are plentiful.
Beer humor aside, why would beer be worth so much effort? Maybe ancient man found that alcohol calmed his (and her) instinctual angst, and, thus, allowed more freedom from social instinct. By allowing transcendence of biological angst, it played a role in allowing the development of civilization. Alcohol enabled us to dampen painful social instincts as we tried to follow rational thoughts about social roles. That would make it the first widely used psychopharmacological medication.”
So, studies suggest, Beer Lubricated the Rise of Civilization. And, Jeffrey Kahn suggests in this book, it did so by calming our angst. An angst which is instinctual and has deep evolutionary origins. These evolutionary origins (and not the origins of beer) are the main message of this book. And that’s an eye-opener for those of us who have assumed that anxiety and depression are modern ailments. Arising from the stress of our modern society. Or from our species’ ability to ruminating, reflect on, and be obsessed by, our thoughts.
Those evolutionary origins really are deep:
“the social instincts of our primeval ancestors evolved so that they could all live more effectively in ancient communities, and so that they could more successfully pass on their DNA. Life back then was about harmonious collaboration for communal living and basic survival. . . . . our ancestors evolved biologically from solitary survival to group living some 52 million years ago, and then on to pair living (or male-led harems) some 16 million years ago. Most primate groups are similar even today, but modern human social groups have been enhanced by our more recent developments of Consciousness and civilization.”
So it’s not just a matter of hominids or primates. It goes right back.
Instinctual basis of today’s angst
The book covers five common subtypes of anxiety and depression – Panic Anxiety, Social Anxiety, Obsessive-Compulsive Disorder, Atypical Depression and Melancholic Depression. The author devotes some time to more accurately defining these and describing their symptoms. He also provides a useful appendix of diagnostic criteria. But the book mainly argues that these types of anxiety and depression arise from our instincts which had their evolutionary origin long ago in maintaining the social behaviour of our ancient ancestors.
Panic Anxiety: derived from instincts that prevented us straying to far from the home or group. Survival depended on us finding our way back to the group – safe from predators and other catastrophes.
Social Anxiety: based on those instincts that kept us in line in our tribal social hierarchies to keep the peace at home. Order maintained by shame and embarrassment produced by not knowing your primeval rank.
Obsessive Compulsive Disorder: arising from our instincts to clean, arrange, save and behave for a sure and tidy nest. To do the things which enabled people to live together safely.
Atypical Depression: coming from our instincts to avoid rejection, remorse and exile from the group. Instincts necessary to keep us well-enough behaved for a cooperative society.
Melancholic Depression: Based on the instinct encouraging us to “take one for the team” if you are too old or too ill. This helped to reduce pressure on scarce resources when we were no longer useful to the group.
Kahn adds a sixth evolutionary derived instinct which is not necessary behind recognised mental illnesses but has been important to our social evolution
Consciousness: the instinct to thoughtfully consider others and understand problems. This helped us be responsive to our companions and environment.
Civilization and instincts
Our instincts did not disappear with our civilisation. On the one hand their role sometimes has to be reduced or suppressed. On the other hand civilisation often enables freer hand to “anti-social,” behaviour.
“As human civilization developed over the last 10,000–100,000 years (give or take), there was less reliance on the instinctual social roles essential to primeval tribes, and there was greater opportunity and need for independent thought and behavior. Civilization brought more social opportunity to Everyman. An everyday member of the tribe could decide to play a more prominent or successful role—that is if he or she was willing to tolerate a bit of angst. Real civilization takes more than a village—it needs free-thinking individuals. As we will see, the most free thinking of all are oft en troubled by anxiety and depression.”
And, beer jokes aside, civilisation provides other ways of overcoming or reducing the negative role these instincts may play on human behaviour.
“Civilization has its discontents, perhaps because our inbuilt social instincts are still there. So, civilization has developed correctives such as government, laws, democracy, religion, beer, and healers to help us.”
Practical advice for the reader?
These days we are more honest about mental illness than we were in even the recent past. We recognise that many people are prone to anxiety or depressive disorder and are far less judgemental about this than we used to be. Just as well:
“The commonplace anxiety and depressive disorders are very commonplace indeed. They are mostly chronic, and they affect at least 20% of the United States at any one time. That’s about 60 million people. So why is that? Nobody likes anxiety and depression, but we end up with them anyway, and it’s probably always been that way. If they are so common, they must have served some kind of purpose for us in our evolutionary past.”
Recognition of the deep evolutionary origins of the intuitions leading to these disorders should encourage this rejection of judgemental approaches. It should encourage sufferers, with the support of their families and friends, to seek the medical and psychological help that is available today.
Kahn draws from his experience as a clinical practitioner and mentions both therapeutic and pharmaceutical treatments used for each condition he discusses. Both of these have their supporters and detractors and some readers may be disappointed that he gives the most detailed consideration to pharmaceutical treatments. Maybe that reflects his particular interests. Or maybe it reflects the fact that he gives little consideration to the way that human self-awareness and our ability to reflect on our thoughts, re-live our memories and obsess about both, contributes to metal illness. And the possibilities that reflection and self-awareness can be used, through therapy, to aid recovery.
So, personally I would have preferred a bit more detail about the different forms of psychotherapy used and their efficacy.
However, the main message – that our psychological problems have deep evolutionary causes in the intuitions animals required for their interaction with each other and to live in groups, is convincingly presented. Many readers will find this idea new and will appreciate the lesson.
This is not a self-help book. Readers who recognise any disorders in their own behaviour are of course advised to consult their own doctor or medical expert who can recommend the most suitable treatment. And recognition of the deep evolutionary origins of their problem may make this easier for them.