Can we adapt to this new reality?

As we attempt a return to a semblance of normality, behavioural strategies to reduce the transmission of infection have never been more important. Dr Stephen Blumenthal, clinical psychologist, considers the behavioural immune system – cross cultural differences in behaviours adapted over millennia to reduce contagion. Is this a moment when we change the way we think and interact?

Working as a collective is very effective in some situations. The idea of the wisdom of the crowd holds that birds flock together when they fly south for the winter in order to correct for navigational error. When it comes to organising ourselves as a society in the West, we have tended to shun such ideas in favour of individualism and self-determination. This may have been good for wealth generation, but prevalence and mortality rates suggest that it’s not so great for fighting a pandemic. We are warned that the West could go the way of Athens which gave way to Sparta after a plague undermined its institutions, and two great plagues contributed to the fall of Rome. Could this be a defining moment in global history when the balance of power shifts as a result of a pandemic?

In much the same way we develop immunity from controlled exposure to viruses, we have evolved what evolutionary psychologists call a behavioural immune system – behavioural strategies developed over millennia which protect us from infection. This system functions differently between people and across cultures, and is likely a major reason why rates of infection from Covid-19 have been so variable across the world. Perception of risk and adherence to public health messages are playing out differently across the globe – from Asia through Europe to the US there is a clear gradient in mask use, and the implementation and the observance of social distancing. A man I see who suffers with a chronic illness and has been shielding tells me of his disquiet right now: ‘At the beginning of lockdown we were all in it together, but now there are lots of people not taking heed of the risks even though infections are on the rise. That might be fatal for me’.

Research finds that these anti-pathogen behavioural strategies affect all kinds of human behaviours: disgust in response to substances that might carry pathogens, social isolation when contagious, our culturally defined greeting rituals – do I kiss once, twice, three times, do I shake hands or do I bow – amongst many others

When you look at the geographical spread of pathogens around the world, the nations with greatest pathogen stress – that is the areas with greater concentration of microorganisms which cause disease in the environment – people tend to be less extraverted and less open to new experiences. There is also more pressure to conform to social norms.

Parasite prevalence is also predictive of political attitudes – it is a strong predictor of collectivist value systems [and see also The Psychologist, November 2009]. In fact, the theory goes, ideology evolved alongside pathogens. An aspect of the development of conformist and collectivist ideology is attributable to the spread of disease in particular areas, because ideology translates into stratagems which avoid infection in the population

There are doubtlessly many influences on why some countries have done better than others in their management of coronavirus. Cultural variability in infection rates and morbidity is strikingly correlated with cultural variation in a conception of self as independent versus interdependent. Anglo-American values endorsing individualism and independence are contrasted with cultures which share a stronger commitment to collectivism and are interdependent, like China, Singapore and Japan, where the culture is better evolved and therefore prepared for this pandemic. Resistance to mask use could be understood as an assault on deeply ingrained aspects of cultural identity, which in turn are rooted in biology.

I have been struck by the variability in attitudes towards coronavirus as communicated to me in the consulting room. 'John', for example, is an inhibited and withdrawn man who is rather deferential and obedient. He describes his sudden realisation whilst shopping at the supermarket that he forgot to take a mask: ‘I felt I was in one of those dreams, he tells me, ‘when you’re naked in public’. This triggers him into action to find the aisle with the masks so he can re-clothe himself, pronto. Contrast this with Danny, an assertive extravert who cannot understand why we are sacrificing our economy for the sake of ‘a handful of fatalities’. Each time we meet on Zoom, he asks me why we continue to have therapy remotely and when will we return to seeing each other face-to-face. He describes resenting the ‘Nanny State’, flouting lockdown rules and ‘just getting on with life’. 

Shunning the use of masks or ignoring lockdown rules are inconceivable in those parts of the world who have best managed the virus. Individualism is good for many things, but we are poorly adapted to fight this battle. A population that doesn’t cooperate, where there is a philosophy of independence to the exclusion of interdependence, is going to be hit hard by a pandemic and will grimly reap more infection and more death. 

We have not had a major pandemic since the Spanish Flu and at least in the Western world, the disadvantages of behavioural immunity have outweighed the benefits. Our lifestyles involving greater liberalisation, being more global, taking more flights, enjoying the benefits of greater contact between people and the freedom to decide our own destinies are fertile ground for proliferation. We are incredibly vulnerable to the spread of disease in the Western world, our culture and therefore our structures are poorly adjusted. What now for the way in which we organise ourselves? As the wheels of education and industry begin to turn again, will we be able to balance our social, psychological and economic needs for physical proximity with our need of health and the attendant behavioural strategies which promote it? Coronavirus is a laboratory of the human conditionPrevious chapters of our political history were imprinted by our biology over millions of years. How will the next chapter be written?

Dr Stephen Blumenthal is Consultant Clinical Psychologist & Psychoanalyst at the Portman Clinic, Tavistock & Portman NHS Foundation Trust, and Queen Anne Street Practice

See also Dr Blumenthal's piece on gender relations coming out of lockdown.

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