Friday, September 6, 2013

Social Isolation Is Toxic

When therapists treat trauma victims they often recommend a change of heart and mind. For many therapists neutralizing trauma means rearranging emotions, thoughts, and desires.

New research has suggested that this approach fails to give sufficient weight to the fact that human beings are social animals and that the presence or absence of social connections determines how well or poorly anyone can process a trauma.

Scientists are researching this issue on several different fronts. A recent and comprehensive article by David Dobbs in Pacific Standard reports on how the question is being studied in terms of bees, birds and humans. (Thanks to TL for passing it along.)

Surprisingly, scientists have discovered that socialization effects the way genes express themselves. When a young honeybee is placed in a hive of African bees some of its genes will express themselves differently, to the point where the bee will become far more aggressive, adopting the characteristics of an African bee.

Entomologist Gene Robinson of the University of Illinois performed the experiments:

 For the bees that had been kidnapped, life in a new home had indeed altered the activity of “whole sectors” of genes. When their gene expression data was viewed on the cards alongside the data for groups of bees raised among their own kin, a mere glance showed the dramatic change. Hundreds of genes had flipped colors. The move between hives didn’t just make the bees act differently. It made their genes work differently, and on a broad scale.

These bees didn’t just act like different bees. They’d pretty much become different bees. To Robinson, this spoke of a genome far more fluid—far more socially fluid—than previously conceived.

In related research, UCLA biologist Steve Cole has shown that social isolation, or anomie has a distinct and measurable effect on the human immune system: 

“We typically think of stress as being a risk factor for disease,” said [UCLA professor Steve] Cole. “And it is, somewhat. But if you actually measure stress, using our best available instruments, it can’t hold a candle to social isolation. Social isolation is the best-established, most robust social or psychological risk factor for disease out there. Nothing can compete.”

This helps explain, for instance, why many people who work in high-stress but rewarding jobs don’t seem to suffer ill effects, while others, particularly those isolated and in poverty, wind up accruing lists of stress-related diagnoses—obesity, Type 2 diabetes, hypertension, atherosclerosis, heart failure, stroke.

Dobbs explains that:

… psychologists at Carnegie Mellon finished a well-controlled study showing that people with richer social ties got fewer common colds.

Something about feeling stressed or alone was gumming up the immune system—sometimes fatally.

“You’re besieged by a virus that’s going to kill you,” says Cole, “but the fact that you’re socially stressed and isolated seems to shut down your viral defenses. What’s going on there?”

Yale psychiatrist Joan Kaufman has studied the effects of “social support” on mental illness. She demonstrated that people with poor social ties were more vulnerable to fall ill when faced with stress or trauma:

The Kaufman study at first looks like a classic investigation into the so-called depression risk gene—the serotonin transporter gene, or SERT—which comes in both long and short forms. Any single gene’s impact on mood or behavior is limited, of course, and these single-gene, or “candidate gene,” studies must be viewed with that in mind. Yet many studies have found that SERT’s short form seems to render many people (and rhesus monkeys) more sensitive to environment; according to those studies, people who carry the short SERT are more likely to become depressed or anxious if faced with stress or trauma.

But then, Kaufman made a fascinating discovery:

Kaufman looked first to see whether the kids’ mental health tracked their SERT variants. It did: The kids with the short variant suffered twice as many mental-health problems as those with the long variant. The double whammy of abuse plus short SERT seemed to be too much.

Then Kaufman laid both the kids’ depression scores and their SERT variants across the kids’ levels of “social support.” In this case, Kaufman narrowly defined social support as contact at least monthly with a trusted adult figure outside the home. Extraordinarily, for the kids who had it, this single, modest, closely defined social connection erased about 80 percent of the combined risk of the short SERT variant and the abuse. It came close to inoculating kids against both an established genetic vulnerability and horrid abuse.

To me, this confirms that it’s not the abuse that harms people as much as the social isolation. Thus, human connection is the most powerful therapy for traumatic abuse.

Clearly, Kaufman is not talking about a deep and meaningful connection; she is offering something that might be a superficial but socially significant connection that affirms the individual as a social being.

If a therapist works at establishing a connection with his patient he can effectively help him to overcome trauma. But the victim would also be helped by meetings with the basketball coach.

Meeting with a therapist or a psychiatrist labels the person a victim. Meeting with the coach signifies that he is a member of a team. The latter is more therapeutic than the former.

Obviously, this challenges the way psychiatrists and psychologists treat abuse. But also, it contradicts their assumptions about human beings.

Dobbs frames the question:

Or, to phrase it as Cole might, the lack of a reliable connection harmed the kids almost as much as abuse did. Their isolation wielded enough power to raise the question of what’s really most toxic in such situations. Most of the psychiatric literature essentially views bad experiences—extreme stress, abuse, violence—as toxins, and “risk genes” as quasi-immunological weaknesses that let the toxins poison us. And abuse is clearly toxic. Yet if social connection can almost completely protect us against the well-known effects of severe abuse, isn’t the isolation almost as toxic as the beatings and neglect?

The Kaufman study also challenges much conventional Western thinking about the state of the individual. To use the language of the study, we sometimes conceive of “social support” as a sort of add-on, something extra that might somehow fortify us. Yet this view assumes that humanity’s default state is solitude. It’s not. Our default state is connection. We are social creatures, and have been for eons. As Cole’s colleague John Cacioppo puts it in his book Loneliness, Hobbes had it wrong when he wrote that human life without civilization was “solitary, poor, nasty, brutish, and short.” It may be poor, nasty, brutish, and short. But seldom has it been solitary.


Anonymous said...

In Healing the Shame That Binds You, author J. Bradshaw describes the causes of toxic shame along three lines: enmeshment in the emotional needs of others, and inability to moderate one's own feelings of pleasure and pain in relation to the enmeshing persons; verbal and physical abuse, which are actually also painful forms of enmeshment in the needs of othes; and finally abandonment which is the physical absence of others to some degree.

Now all three of these factors cause an abandonment of one's own desire for love, which is pleasure in the presence of others, and a submissive adaptation to the needs of others in a painful context.

Correcting trauma is not at all easy because simple adherence to norms of society can provide a context which brings feelings of loneliness or trauma. The brain generates pain at the thought of touching a hot stove, so if one is wired for pain in a social context how does society help that pain go away?

Anonymous said...

Meeting with a therapist or a psychiatrist labels the person a victim. Meeting with the coach signifies that he is a member of a team. The latter is more therapeutic than the former.

That is profound. I've never seen it put like that. It has worked like that in my own life.