In life, it is not the elephants

John Langhorne/Tree Full of Owls

Every time a person with an automatic weapon kills several people in some public venue a colleague or client asks me “Are we getting crazier?”

For years, I have had a too glib reply: “Yes, we live in a more complex and rapidly changing world.”

After the last interaction of this type I was reconsidering my response because there are at least three questions buried in this query. The issues are rather more nuanced than appears at first glance.

The first question: Overall are people having more mental and emotional problems than in previous decades? If we define crazy as “stressed out” we see the first and perhaps most relevant facet of this question.

My mother, who had very little formal education but lots of practical wisdom often said, “In life it’s not the elephants that get you, it’s the ants.” When I was younger I thought this was nonsense.

She was probably correct.

In the modern world, most of us will rarely, if ever, experience a direct physical, violent threat. How many of you have been in a fist-fight? So why do people report such high levels of stress?

The reasons for this appear to be relatively clear: we are genetically hard-wired to survive in a more violent world and the level of change in most cultures makes our environments, although physically safer, more psychologically unpredictable.

There is a type of hard wiring in human beings that gives us a competitive and evolutionary advantage. It is known as the General Adaptation Syndrome (GAS), or more simply, the flight or fight response. We are essentially super-tuned to notice and rapidly react to negative events in our near environment. This is why one caustic comment has more impact than a dozen compliments.

The GAS works fine when a group of warriors is facing off against a predatory carnivore. But consider this not a typical day. You are having a perfectly fine time until your boss states, in the presence of others and in a threatening manner, that the recent work you had just finished was rather poor. You then return to your computer and notice a key file is missing. An e-mail pops up, clearly a “reply to all” and a colleague has made a rather sarcastic remark about you and mailed it to a cast of thousands. The phone rings and a customer spends several minutes berating you about a problem she had in your store. Fight or flee? We can do neither and our body is dumping tons of adrenaline into our circulatory system. This is stress and unless you have a tool for dealing with it you have a problem.

Compared to earlier times, our environments are more complex, more events are happening faster and are more unpredictable. There is also compelling research that high, sustained levels of stress can cause physical symptoms adding yet another causative factor. Google “stress management” and you will get more than 20 million hits. Welcome to
the 21st century.

The second question: Is there a relationship between mental illness and violence,
most specifically murder?

For many years, mental health professionals have noted that mental illness is not a causal factor in extreme violence. It is generally accepted that the best predictor of future behavior is past behavior.

There is substantial evidence to support this view. Consider this example: third
grade teachers can predict with quite high accuracy the children in their classes
who will be incarcerated in their late teens and early 20s. The behavior they
use is what psychiatrists call “un-socialized aggression.” An excellent and readable review article, www.ncbi.nlm.nih.gov/pmc/articles/PMC1525086/, implies that the increased level of violence in the mentally ill experienced by mental health professionals is a result of a complex set of changes that effect the care of the mentally ill. It is important to note that these events mostly occur in acute care situations, such as emergency rooms.

So the answer is: If people have not demonstrated violence, murder being the ultimate form of violence, in the past, probably not.

The third question: Are we becoming crazier? If we define crazy as “psychiatrically
impaired,” the answer issue becomes even more complex.

The most negative type of environment and one that has profoundly negative effects on people is war. In his recent book, “Winning The War On War,” Joshua Goldstein presents data showing the decline of wars since 1945 has been dramatic.

In “The Better Angels of Our Nature: Why violence Has Declined,” Steven Pinker makes the case that current times are probably the most peaceful in all of history.

For a fascinating interview of these two authors, visit www.npr.org/2011/12/07/143285836/war-andviolence-on-the-decline-in-moderntimes. Paradoxically, we live in a world where the level of physical threat has declined markedly and the variety and frequency of psychiatric problems has expanded steadily. If we used the Diagnostic & Statistical Manual (DSM) of the American Psychiatric Association, the  number of disorders has increased from 106 in 1952 to 374 in 2000 and is being revised
upward in a 2013 revision.

Food for thought.