Using the placebo effect as a foundation, Humphrey wonders if it is possible to co-opt that system, which is partly based in "permission" given by the cultural environment, to release other capabilities that are generally considered beyond our control.
The Evolved Self-Management System
Nicholas Humphrey [12.5.11]
I'm now thinking about a larger issue still. If placebo medicine can induce people to release hidden healing resources, are there other ways in which the cultural environment can "give permission" to people to come out of their shells and to do things they wouldn't have done in the past? Can cultural signals encourage people to reveal sides of their personality or faculties that they wouldn't have dared to reveal in the past? Or for that matter can culture block them? There's good reason to think this is in fact our history.
NICHOLAS HUMPHREY has held posts at Oxford and Cambridge Universities, and is now School Professor Emeritus at the LSE. He is a theoretical psychologist, internationally known for his work on the evolution of human intelligence and consciousness. His most recent book is Soul Dust.
Nicholas Humphrey's Edge Bio Page
THE REALITY CLUB: Geoffrey Miller
THE EVOLVED SELF-MANAGEMENT SYSTEM
NICHOLAS HUMPHREY: I was asked to write an essay recently for "Current Biology" on the evolution of human health. It's not really my subject, I should say, but it certainly got me thinking. One of the more provocative thoughts I had is about the role of medicine. If human health has changed for the better in the late stages of evolution, this has surely had a lot to do with the possibility of consulting doctors, and the use of drugs. But the surprising thing is that, until less than 100 years ago, there was hardly anything a doctor could do that would be effective in any physiological medicinal way—and still the doctor's ministrations often "worked". That's to say, under the influence of what we would today call placebo medicine people came to feel less pain, to experience less fever, their inflammations receded, and so on.
Now, when people are cured by placebo medicine, they are in reality curing themselves. But why should this have become an available option late in human evolution, when it wasn't in the past.
I realized it must be the result of a trick that has been played by human culture. The trick is to persuade sick people that they have a "license" to get better, because they're in the hands of supposed specialists who know what's best for them and can offer practical help and reinforcements. And the reason this works is that it reassures people—subconsciously —that the costs of self-cure will be affordable and that it's safe to let down their guard. So health has improved because of a cultural subterfuge. It's been a pretty remarkable development.Read the rest of the article and Miller's reply.
I'm now thinking about a larger issue still. If placebo medicine can induce people to release hidden healing resources, are there other ways in which the cultural environment can "give permission" to people to come out of their shells and to do things they wouldn't have done in the past? Can cultural signals encourage people to reveal sides of their personality or faculties that they wouldn't have dared to reveal in the past? Or for that matter can culture block them? There's good reason to think this is in fact our history.
Go back 10 or 20,000 years ago. Eccentricity would not have been tolerated. Unusual intelligence would not have been tolerated. Even behaving "out of character" would not have been tolerated. People were expected to conform, and they did conform, because they picked up the cues from their environment about the right and proper—the adaptive—way to behave. In response to cultural signals people were in effect policing their own personality.
And they still are. In fact we now have plenty of experimental evidence about the operation of "sub-conscious primes", how signals from the local environment get to people without their knowing it and, by changing their character and attitudes, regulate the face they present to the world. It can be a change for the worse (at least as we'd see it today). But so too it can be a change for the better. People become, let's say, more pro-social, more generous.
Let's take this particular example. What cues might people pick up on that would turn them into nicer people? Well, remarkably enough just seeing something out of the corner of one's eye which suggests that other people are behaving nicely can do it. There's a wonderful experiment I heard described at a conference in Kyoto a few months ago. What the Japanese scientists did was to get their subjects to play a cooperation game, a prisoner's dilemma game, online. Subjects could choose to act generously, trust the opponent, or mistrust and default on the exchange.
Now, to one side of the computer on which subjects were playing this game, the experimenters had set up another computer with a screen-saver on it. There were two conditions. In one the screen-saver showed a little animation of two balls, one of which was helping another one over a barrier, coming up underneath it and giving it a shove-over; in the other, one of the balls was hindering another from getting over the barrier by getting in its way.
Astonishingly, the subjects of this experiment who had the cooperative animation running on the screen to one side were twice as likely to cooperate in their game with another player online, even though they didn't acknowledge that they'd noticed anything on the secondary screen. And even if they had noticed it, so what? I mean why should they copy something which is just going on a screen-saver?
But this is just one example. Now almost every month's issue of Psychological Science, for instance, reports some striking new finding about how cues from the surroundings can change people's nature. Moral judgments, reasoning skills, personal hygiene, political attitudes —you name it—are all proving to be unexpectedly malleable, as people respond to the social and physical weather signals that their brains (if not their conscious minds) pick up on.
It's been a tremendous surprise for experimental psychology and social psychology, because until now it's been widely assumed that people's characters are in fact pretty much fixed. People don't blow with the wind, they don't become a different kind of person depending on local and apparently irrelevant cues . . . But after all, it seems they do.
So what's going on? We need a theory.
You'll have guessed the way I want to take it. I began with the placebo effect. To explain placebos I think we need to invoke the existence of an "evolved health management system". The placebo effect is a particular kind of priming effect. And what I want to do now is to explain a whole range of other priming effects by invoking the existence of an "evolved self-management system".
Let's start over again with placebos. Some years ago I drew attention to the "paradox of placebos", a paradox that must strike any evolutionary biologist who thinks about it. It's this. When a person's health improves under the influence of placebo medication, then, as we've noted already, this has to be a case of "self-cure". But if people have the capacity to heal themselves by their own efforts, why not get on with it as soon as needed? Why wait for permission—from a sugar pill, a witch doctor—that it's time to get better?
Presumably the explanation must be that self-cure has costs as well as benefits. What kind of costs are these? Well, actually they're fairly obvious. Many of the illnesses we experience, like pain, fever and so on, are actually defenses which are designed to stop us from getting into more trouble than we're already in. So "curing" ourselves of these defenses can indeed cost us down the line. Pain reduces our mobility, for example, and stops us from harming ourselves further; so, relieving ourselves of pain is actually quite risky. Fever helps kill bacterial parasites by raising body temperature to a level they can't tolerate; so again, curing ourselves of fever is risky. Vomiting gets rid of toxins; so suppressing vomiting is risky.
The same goes for the deployment of the immune system. Mounting an immune response is energetically expensive. Our metabolic rate rises 15 percent or so, even if we're just responding to a common cold. What's more, when we make antibodies we use up rare nutrients that will later have to be replaced.
Given these costs, it becomes clear that immediate self-cure from an occurrent illness is not always a wise thing to do. In fact there will be circumstances when it would be best to hold back from deploying particular healing measures because the anticipated benefits are not likely to exceed the anticipated costs. In general it will be wise to err on side of caution, to play safe, not to let down our defenses such as pain or fever until we see signs that the danger has passed, not to use up our stock of ammunition against parasites until we know we're in relatively good shape and there's not still worse to come. Healing ourselves involves—or ought to involve—a judgment call.
It makes sense that our brains should have come to play a crucial part in the top-down management of bodily health. As I see it, what the health management system has evolved to do is to perform a kind of economic analysis of what the opportunities and the costs of cure will be: what resources we've got in reserve, how dangerous the situation is right now, what predictions we can make of what the future holds. In effect the system acts like a good hospital manager who has to decide just what resources to keep in store, how quickly to treat a patient, how long before discharging them, etc., overall trying to produce an optimal outcome on the basis of a forecast about what's coming down the road: whether there's another epidemic looming, for example, or whether we're entering a season where there won't be enough food available.
There's plenty of evidence that we have just such a system at work overseeing our health. For example, in winter, we are cautious about deploying our immune resources. That's why a cold lasts much longer in winter than it does in summer. It's not because we're cold, it's because our bodies, based on deep evolutionary history reckon that it's not so safe to use our immune resources in winter, as it would be in summer. There's experimental confirmation of this in animals. Suppose a hamster is injected with bacteria which makes it sick—but in one case the hamster is on an artificial day/night cycle that suggests it's summer; in the other case it's on a cycle that suggests it's winter. If the hamster is tricked into thinking it's summer, it throws everything it has got against the infection and recovers completely. If it thinks it's winter then it just mounts a holding operation, as if it's waiting until it knows it's safe to mount a full-scale response. The hamster "thinks" this or that?? No, of course it doesn't think it consciously—the light cycle acts as a subconscious prime to the hamster's health management system.
So now, where does the placebo effect fit in? Placebos work because they suggest to people that the picture is rosier than it really is. Just like the artificial summer light cycle for the hamster, placebos give people fake information that it's safe to cure them. Whereupon they do just that.
This suggests we should see the placebo effect as part of a much larger picture of homeostasis and bodily self-control. But now I'm ready to expand on this much further still. If this is the way humans and animals manage their physical health, there must surely be a similar story to be told about mental health. And if mental health, then—at least with humans—it should apply to personality and character as well. So I've come round to the idea that humans have in fact evolved a full-blown self management system, with the job of managing all their psychological resources put together, so as to optimise the persona they present to the world.
You may ask: why should the self need any such "economic managing"? Are there really aspects of the self that should be kept in reserve? Do psychological traits have costs as well as benefits? But I'd say it's easy to see how it is so. Emotions such as anxiety, anger, joy will be counterproductive if they are not appropriately graded. Personality traits—assertiveness, neuroticism, and friendliness—have both down- and up-sides. Sexual attractiveness carries obvious risks. Pride comes before a fall. Even high intelligence can be a disadvantage (we can be "too clever by half", as they say). What's more—and this may be the area where economic management is most relevant of all— as people go through life they build up social psychological capital of various kinds that they need to husband carefully. Reputation is precious, love should not be wasted indiscriminately, secrets have to be guarded, favors must be returned.
So, I think humans must have come under strong selection pressure in the course of evolution to get these calculations right. Our ancestors needed to develop a system for managing the face they present to the world: how they came across to other people, when to flirt, when to hold back, when to be generous, when to be mean, when to fall in love, when to reject, when to reciprocate, when to punish, when to take the lead, when to retire, and so on. . . All these aspects had to be very carefully balanced if they were going to maximize their chances of success in the social world.
Fortunately our ancestors already had a template for doing these calculations, namely the pre-existing health system. In fact I believe the self management system evolved on the back of the health system. But this new system goes much further than the older one: it's job is to read the local signs and signs and forecast the psychological weather we are heading into, enabling us to prejudge what we can get away with, what's politic, what's expected of us. Not surprisingly, it's turned out to be a very complex system. That's why psychologists working on priming are discovering so many cues, which are relevant to it. For there are of course so many things that are relevant to managing our personal lives and coming across in the most effective and self-promoting ways we can.
Once we have a theoretical understanding of how all this works, can we exploit it in practical ways to change people's lives for the better? Does it offer us tools for social engineering?
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