Can Evolution Explain Human Emotions? - Dr Randy Nesse

1. 0:00 – 0:24

   Intro

   1. RNRandy Nesse0:00

      What's the situation in which a panic attack is useful? You start suddenly feeling like your heart is pounding. You start getting short of breath. Your muscles tighten up. You feel like you're maybe going crazy and you've got to get out of there, wherever you are. So that is a perfect suite of things to get you out of life-threatening danger. It's- it's a fight or flight response, a pre-programmed emergency response. But why would it go off when it's not needed?

   2. CWChris Williamson0:22

      I saw

2. 0:24 – 5:11

   Are Humans Designed for Happiness?

   1. CWChris Williamson0:24

      a quote from Robert Wright's Why Buddhism is True, which says, "Humans are designed to be effective, not happy." How accurate do you think that is?

   2. RNRandy Nesse0:34

      That's so sad. One of the first articles that I wrote is why happiness is so elusive from an evolutionary viewpoint. And everybody wants to be happy. Everybody tries to be happy. There are all kinds of businesses and professionals and therapists who help us be happy, and it's not working very well. And there's a very specific answer, is that the whole damn system is not designed for happiness. It's designed, as Robert Wright knows all so well, uh, for maximizing gene transmission. What a bitch.

   3. CWChris Williamson1:01

      (laughs) So-

   4. RNRandy Nesse1:04

      It's- it's ter- It actually is- I- I joke about it a little bit, but I- I think it's a terrible, traumatic, awful thing. Uh, natural selection doesn't give a fig about our fitness or- or about our happiness. A- and so a lot of people are just wandering around all the time miserable 'cause the system is shaped to, you know, goad them to do stuff that is not in their interests, it's in their genes interests, and it makes me a little pessimistic sometimes about, you know, the idea we're all going to be happy if we only do the right thing and think the right way, you know? O- on the other hand, that way of deeper thinking, I'm so glad you mentioned B- Bob Wright, 'cause I'm very impressed by him and his work. And he's right. Desire is the problem, right? Um, we all have all these desires and none of us can satisfy all of them, and it's all built into the design.

   5. CWChris Williamson1:50

      "Desire is a contract you make with yourself to be unhappy until you get what you want." That's from Naval Ravikant.

   6. RNRandy Nesse1:57

      You know, I- I don't buy that. Desire is something that pushes us to do stuff that's good for our genes, and it doesn't matter what we accomplish. As soon as we do it wants us to do something more. And so there's- there's no winning that particular one, the hedonic treadmill and all that.

   7. CWChris Williamson2:10

      I was talking to a couple of friends who were recently on a very big podcast over here in Austin, and one of them mentioned that he was fearful of gold medalist syndrome, which I wasn't familiar with, but I went and learned about afterward, which is after you've completed the crowning achievement of your life's work, well, what- what do you do next? What hap- wha- what happens after that?

   8. RNRandy Nesse2:31

      So actually, I've- I've been... I wrote only a little bit about this, but I'd like to do more about it. But it seems to me there's something built in that after a great success, we always feel down. And it's not just winning a gold medal, it's there's, you know, getting a paper done, you know, or- or doing a great podcast. Afterwards, we always feel low. Why? A- and- and there's a bunch of psychology about this, so opponent process is the technical name. Um, but it seems to me that that's probably necessary to keep us from flying off into mania, and to stabilize mood, you got to keep it from getting into a positive feedback mood where success made you feel better, which makes you feel more mood. I mean, that's what happens with mania, right? Uh, you succeed at something, you start flying off, and you get to succeed at more, and everything seems great until you're, you know, in the hospital or something. I think it's much better for the system to be programmed to just bring you down, uh, quite promptly after some grand success.

   9. CWChris Williamson3:25

      Is it the job of humans then, if we are permanently stuck in this vacillating to an upper bound of happiness that we- is inevitably going to be brought back down by our hedonic adaptation, uh, how do people avoid just being nihilistic with that? How do they think, well this is all futile. What's the point in even trying to do anything? Even if I make myself happy, it's going to be pointless because I'm going to be brought back to baseline within the next three days.

   10. RNRandy Nesse3:51

       Hmm. You know, we feel happier when we accomplish things that we want to do. And, you know, there- there's one little quote from my book that's, uh, gets- that's retweeted every week by somebody for the last year. And the gist of it is that what makes us, you know, gives us pleasure is not actually accomplishing our goals, and what gives us happiness is making progress towards goals. And getting there is not such a good thing, but making progress towards a goal. This means you got to have a goal of some sort. Not something grand necessarily, but fixing dinner, you know, or- or having a fun podcast, or getting your Yeti microphone to work. Um, that our life is just consumed by all of these little goals that we are all in competition with each other. Um, but- but that's the problem, isn't it? Um, there are so many things, uh, that we do, and most of them are in competition with each other. And if you want to be a superstar, uh, most superstars are really focused on one thing to the exclusion of other things, and this is not a balanced life, but it is a route to stardom. And, you know, this- this is a problem especially in this age when everybody's trying to be super duper on the web. Um, it's just not possible to be the best and to have a balanced life. I don't think. Maybe some people seem to pull it off, but

   11. CWChris Williamson5:07

       I think it's very...

   12. RNRandy Nesse5:09

       ... it's very hard.

   13. CWChris Williamson5:09

       The- the- those people that are

3. 5:11 – 11:53

   How Elite Performers Can Find Balance

   1. CWChris Williamson5:11

      able to be elite at what they do and have a balanced life are significantly more rare than the people that are elite at what they do who by design are incredibly rare.

   2. RNRandy Nesse5:21

      (laughs)

   3. CWChris Williamson5:21

      And a perfect example of this is Tiger Woods did a charity golf game where he was with, I- I don't know, J- Jared Leto or- or Brad Pitt or someone. It wasn't, but somebody like that, right? And they're walking around the golf course, and because it's for a charity game, uh, they were...... lapel mic'd up for the entire time. And Rory McIlroy as well, uh, who's a British player, he was there too.

   4. RNRandy Nesse5:43

      Yeah.

   5. CWChris Williamson5:43

      And, uh, the mic was capturing what they said. And you usually don't get to hear what the player is speaking to his caddy about, right, throughout the most of the game, obviously.

   6. RNRandy Nesse5:51

      Right, right.

   7. CWChris Williamson5:52

      And, um, you got to hear the difference in the way that Tiger approaches his game with the way that, uh, Rory approaches his. So, as they were walking around, Tiger and his partner... And he's some guy, right? Maybe he plays a bit of golf or whatever, but he's not a pro. And Tiger's talking about-

   8. RNRandy Nesse6:07

      Yeah. Yeah.

   9. CWChris Williamson6:07

      "... Okay, so you're gonna notice the, the fairway is going to fall away a little bit to the right here. You're gonna have to open the face a little bit. I'm rea- I really don't want you to go for too much of a high loft club because we've got this humidity in the air," and blah, blah, blah.

   10. RNRandy Nesse6:18

       Mm-hmm.

   11. CWChris Williamson6:18

       And then, it cuts to Rory McIlroy. And Rory was asking this guy, he was like, "Look, I, I just can't agree with you that Domino's is superior to Pizza Hut. I, I simply am unable-"

   12. RNRandy Nesse6:29

       (laughs)

   13. CWChris Williamson6:29

       ... to..." Oh, he was talking about his favorite sort of pizza or something like that. And you see, uh, uh, that really made me think about Rory as an incredibly singular individual, somebody that's able to turn it on and able to turn it off even during the game. And I'm sure if it was the PGA Finals and whatever, whatever, he's gonna feel a lot more pressure. But in that moment-

   14. RNRandy Nesse6:49

       Yeah.

   15. CWChris Williamson6:49

       ... even the most relaxed game, knowing he was mic'd up, Tiger couldn't switch it off.

   16. RNRandy Nesse6:55

       Yeah, yeah. You know, there are different ways of doing things. There's zen in the art of archery, you know, where, you know, if you're really, really good, your lower brain takes over, you don't have to think about things quite so much. Uh, but when there are other people who are always analyzing and there's different ways to get there.

   17. CWChris Williamson7:11

       Why does the capacity for low mood exist at all?

   18. RNRandy Nesse7:16

       Oh, you pushed one of my buttons. I knew you'd ask that. Um, I mean, first of all, let's just pause for a second. It doesn't have to be there, right? Uh, natural selection could have shaped us to feel pretty good all the time and not to have all these moods going up and down and sideways. Um, why didn't it do that? So, we have to ask, first of all, why have mood at all? And the answer is that there are good times to do things and there's bad times to do things. And sometimes a little bit of investment will give you a big payoff, and sometimes a, a big investment will get you nothing. Um, I think about my ancestors, uh, for the last 1,000 years on a tiny island in the North Sea off the coast of Norway. And I every once in a while imagine one of them that was very optimistic a few 100 years ago, trekking off in February, uh, going off and saying, "I can find some berries or food out there." And, you know, of course, there weren't any ancestor like that. There might have been somebody like that, but they died in the snow and they didn't pass on any genes. The one who was more pessimistic sensibly and, and just didn't think that things were gonna be all great all the time did better. Now, in, in modern life, of course, we're not foraging for berries nearly so much, most of us. We're in social exchanges of all kinds and we're trying to look good for other people. Um, but it's very tricky, isn't it? Because on the one hand, we want friends, on the other hand, we want status, and we, uh, can only have so much time and so many friends, and it's all very complicated. I mean, we're basically foraging for social resources. And it... sometimes it goes well, and sometimes the more you call somebody up, the less they want to talk with you. Um, so there are people who don't have any low mood in that circumstance. They're really annoying (laughs) , you know, because they, they just keep going and keep going and keep going. Uh, I mean, for all of these emotions, Chris, I think there's less attention paid than we should to people who don't have enough low mood, people who don't have enough anxiety, and people with hypophobia, and, and people... 'Cause, you know, it's not wise to just keep going and going. You'd, you'd like an anecdote, uh, from a talk I gave at Cambridge years ago for a positive psychology group. And I told them about how I thought low mood could be useful in circumstances, uh, where you're pursuing an unreachable goal and it really needs to disengage you from wasted effort and taking risks that aren't going to get you anything. And there was deathly silence in the room with all these famous professors and, you know, their whole thing is positive psychology. And I was thinking, "Hey, negative stuff is useful." Um, and then, um, they, they looked at each other and they looked at me and I was kind of thinking, "Well, what do I say now?" But I'm a psychiatrist, so I know how to keep quiet sometimes. And finally, one woman says, "You know, if I had had more low mood, I would have ditched that guy 15 years earlier," and everybody laughed. And it wasn't just funny, uh, because, you know, they're, they're, these moods guide us in, in momentary things and in longer term things. But the problem is a lot of times with people who have depression, um, mood is trying to stop them from doing something that they could actually accomplish. Um, the, the system seems to get broken really easily, and that's one of the things those of us in evolutionary biology try to figure out.

   19. CWChris Williamson10:26

       It seems so ruthless that the evolutionary set point that our minds have been given for the last 150,000 years is so mismatched with the world that we see around us now. The... Uh, but you could argue perhaps, the environment that we have created has mismatched itself to our brains. Perhaps we should be in a place where it would be more adaptive to constantly be... Uh, w- we just release a single tiger on the streets of Manhattan, and then that's going to pretty much match everybody's anxiety level-

   20. RNRandy Nesse10:57

       (laughs)

   21. CWChris Williamson10:57

       ... with the degree of danger that they're in.

   22. RNRandy Nesse10:59

       Right, right. So, I think we should pause here for a second, Chris, and just savor the fact that life is good for a lot of people for whole days and even weeks at a time. I mean, that's astounding, isn't it? We should just appreciate it. I mean, if we were chimpanzees, we'd be beating each other on the fir- on the head and whirling away from people trying to rape us and, you know, it, it's a not a nice life for chimpanzees. Bonobos kind of have more fun, but, you know, sitting around quietly and talking and enjoying each other's company is not something they do. Um, I mean, a lot of people have quite stable, satisfying lives and they're moderately happy a lot of the time. It's just a miracle.And I think just saying its culture doesn't nearly do it justice. I think we have to ask how natural selection shaped us so that we're capable of loving relationships and guilt and, and concern and, and all those kind of things. It's not an easy thing to explain.

4. 11:53 – 16:58

   Do We Pathologise Natural Responses?

   1. RNRandy Nesse11:53

   2. CWChris Williamson11:53

      When it comes to some of the, uh, "diseases," is that people pathologizing normal human responses then?

   3. RNRandy Nesse12:04

      You know, it's not so easy. Um, one of my themes, as you may know, is that you really have to talk with each person one at a time to decide these things. Some, some commentators on the radio say, "Oh, Dr. Nesse, you think low mood is useful, therefore you shouldn't treat it, right?" I say, "No. In fact, I'm sorry to even agree to do an interview with you." Because I mean, it's such a simplistic r- response. Um, but here's a big principle that I've been just starting to write and talk about, Chris. It seems to me that the regulation mechanisms that natural selection shaped result in most bad feelings coming from normal mechanisms about being useless. So how can that be? Um, I mean, the smoke detector principle is one thing that we could talk about. Um, another one is that we live in an environment that's very different from the one we evolved in. Another thing is just bad luck. Another thing is that the system is prone to real dysfunction from getting into positive feedback loops. Um, and this is really bad for depression. And it used to be, you'd have a bad time, somebody would be mad at you, something would happen, and you'd go to your hut, and then you'd get hungry. (laughs) And then you'd come out, and there are a bunch of relatives around, some of whom would want to help you. Nowadays, you move to a different city by yourself, there's nobody else there, and you get in a bad way and you go to your room and you shut the door and you turn off the telephone and then you tell yourself, "Nobody loves me because nobody's calling me," 'cause your phone is turned off. And, you know, don't, don't send any emails. It's a positive feedback cycle of a sort that I don't think existed, um, in nearly that same way, way back when. But now I'm starting to make stuff up. Do we have data on that? No. No, we just kind of go on with our epidemiology comparing people in modern countries. We do not know nearly what we would like to know about what mood problems were like for people in other cultures and, and other states.

   4. CWChris Williamson13:52

      It seems like the fundamental belief held by most people, especially people in the more traditional side of the psychiatry realm, is that if we feel bad, something is wrong. The only reason that you could feel-

   5. RNRandy Nesse14:05

      Oh, that's right. Some- something is wrong, but, but not with the person necessarily. It might well be the situation, but I mean, I spent a year and a half just studying emotions because I realized I had been treating people with emotional disorders for 10 years and I didn't know why emotions existed. Uh, so after just studying emotions, by the way, the, the leading psychiatry textbook, a thousand pages, it had one half of one page about normal emotions. I mean, this is, this is hopeless. Um, in the rest of medicine, you see somebody with fever, you see somebody with cough, you see someone with vomiting, um, you know that those are useful responses and you know what kinds of situations in which they're useful so you go looking for what's wrong. Um, so after that year and a half, I came to a very simple conclusion, which still hasn't, it's catching on, but not as much as I would like. Um, instead of just asking about what's the function of this emotion, which a lot of evolutionary types still do, I think the right question is, in what situation was this emotion useful across our evolutionary history? Because it's those situations that shape the emotion and the regulation mechanism and of course the situations are different now than they were before. Uh, that's, that's one big thing. But also, a lot of those situations can again put positive feedback loops into play. And because if in fact you're anxious and you start getting anxious about being anxious, um, off you are to the races and it's serious anxiety disorder.

   6. CWChris Williamson15:32

      What's the difference between the function and the useful in a situation then? Give us an example.

   7. RNRandy Nesse15:41

      Um, you can find articles that say the purpose of, the function of anger is to signal you're about to attack somebody, or is it the function of anger is to signal that you're going to end the relationship if the person doesn't shape up, or it's a signal of anger to, to say that you are dominant in a dominance competition, or... So you can make up six or eight or 10 of these kind of things and they're all true, kind of, but they're all ways in which anger could give a useful, uh, advantage in one of those situations. A different way of asking it is in what situation is low mood useful? In what situation is anxiety useful? In what situation is anger useful? You know, a generalization I find really helpful in therapy is to think if somebody's really angry, the first thing I think of, "Hey, um, anger is really useful when you think you've been betrayed by somebody." It's a signal that, that person had better apologize and shape up or the relationship is over and, and that helps me ask different questions. It also helps me help my patients to figure out that anger actually sometimes is a useful signal. It's not something always to be avoided. That if that is, it's possible, uh, to potentially threaten to end the relationship. Usually when people yell at each other, it's because they're really dissatisfied, but they can't end it and walk away and it gets into a big mess.

5. 16:58 – 23:15

   Anxiety Attacks in an Evolutionary Context

   1. RNRandy Nesse16:58

   2. CWChris Williamson16:58

      It seems like taking an evolutionary perspective with this allows people that are suffering with emotions, which sadly we all do, to see them with less shame, I suppose?

   3. RNRandy Nesse17:10

      Exactly. Oh, thank you. I'm so glad you got to that. It, it changed my work with my patients and my patients' view of themselves, Chris. Um, I mean, I kept, I, for 10 years, I told patients, "You have an anxiety or mood disorder and it's a problem either with your background or your brain and we're going to give you the standard treatment to fix it." And, and the response of people to that is, "Oh my God, there's something wrong with me. Oh, it's genetic? Um, that can't be fixed, can it?" You know, the whole, whole thing was, I am a defective person.... and that, that changes how you live and how you think about yourself. But once I started saying, "You know what? Um, the responses you're having, these anxiety attacks, they would be useful in life-threatening situations. And you're having really unfortunate, useless false alarms in that system." And then people say, "Oh, well, jeez. So there's something useful about what I have as well? I'm not just a defective human being?" It, it so changes the whole therapeutic relationship and the person's relationship with their symptoms, and it helps them to look thoughtfully about whether the symptoms in their life now might be meaningful and useful, which sometimes they are, or they might be from normal mechanisms but useless, which is the majority of them, or whether they're coming from a mechanism that just is broken and isn't working right. And I think you can have a real conversation with people about those alternatives instead of just assuming, "You've got a broken brain. You know, we've gotta fix it with meds." Or, "You had bad relationships with your parents and that's what caused it." There are so many assumptions that some therapists make about where things come from. And this start- this steps- takes a step back. Instead of asking about the causes for this person's problem, it asks, "Why do we all have systems that are vulnerable to failure?" That, that's the big thing. Why do minds go awry in general?

   4. CWChris Williamson18:55

      I think that the way we experience our own lives, our own, uh, inner world is very much one of agency, sovereignty, the ability to do things.

   5. RNRandy Nesse19:08

      Right.

   6. CWChris Williamson19:08

      Especially, this is now being laid on top with ameritocracy. You are your successes, they're yours to bear. You are your losses, they're yours to bear as well. And when you combine this in a world which has begun to wrangle nature in a way, we can predict the weather, we can fly over oceans, we have science that can defeat diseases and stuff like that, I think all of that combined together gives humans a sense that we should have more agency over everything. Look, the reason that you're in low mood is because you are somehow deficient in yourself. You have caused some-

   7. RNRandy Nesse19:41

      Mm-hmm.

   8. CWChris Williamson19:41

      ... inefficiency to occur and this is your cross to bear. Now, it is your responsibility to fix because it is only you that can do anything in order to be able to move yourself forward. However, you have been born into a system that is, it- it's got all of these bugs in them.

   9. RNRandy Nesse19:59

      Mm-hmm.

   10. CWChris Williamson19:59

       And some of these bugs used to be features.

   11. RNRandy Nesse20:02

       Exactly. And I, I think there's a lot to be said for the, um, novelty of our modern circumstances making us all try to do things we can't do. So, we're all failures. Um, but how much of that... I mean, is it really true that there's a lot more depression now than there was 20 years ago? Data for that is pretty weak, actually. You might've seen in the New York Times articles, uh, for the last week. Um, every day they have a new feature about mental disorders and bad feelings and how we're going to fix them all. And then the thing behind all- part of it is very thoughtful about, A, it's not all pathology. I really appreciate that part. A lot of it is talking about, "Hey, how can we fix it for more people? How can we have simple therapies?" Maybe the most recent one today was about a- an app that you talk to about your feelings and people talking about how y- you can have an app, an artificial intelligence app, do psychotherapy for you. Maybe it's helpful. Um, but what I'd really like people to... The- what, what all those articles are missing though, Chris, is any understanding about why these emotions exist at all and why they're prone to be dysregulated. And y- you almost want to scream a little bit and say, "Wait a second. If you guys were treating pain and nausea and vomiting, you would insist on some kind of investigation for each individual about why those things are happening. And you're not going to stop people's cough, um, just willy-nilly without thinking about it because stopping the cough of somebody with pneumonia might end up killing them. You've got to be thoughtful about it." So, I'd just like to see people understand, um, that these emotions can be useful, at least for your genes, um, and that we should try one by one to understand where they come from in an individual in this particular instance.

   12. CWChris Williamson21:43

       It seems like there's s- a, a hierarchy or multiple layers going on here which is, at the base layer humans have a capacity to sense different types of mental states. That is something-

   13. RNRandy Nesse21:53

       Mm-hmm.

   14. CWChris Williamson21:53

       ... that has been built into us and was at one point presumably adaptive, uh, or might be the side effect of things that used to be adaptive. At a next level is this particular individual human here, what is it that their life is going through or what is it with regards to the way that-

   15. RNRandy Nesse22:09

       Mm-hmm.

   16. CWChris Williamson22:09

       ... they are relating to the world which is causing this particular emotion to come through? So you have the primer, then you have the situation-

   17. RNRandy Nesse22:15

       Right.

   18. CWChris Williamson22:15

       ... which has caused it to happen. And then on the other side of that you have, "Okay, what are we looking to do with regards to treatment for this?" So that sort of hierarchy there.

   19. RNRandy Nesse22:24

       I, I wish you could just say that to all the psychiatry residents in the country, Chris. Um, in, there's so... People want things to be so simple and it's very understandable, right? They want everything to be a brain disorder, everything to be faulty thinking or something. But what you're saying is to use what we understand about why these emotions exist and how they're regulated to try to figure out on a case-by-case basis what's going on and what options are best for helping that individual person. It's profound and it's not something you can do in 15 minutes and make a money- lot of money off of. It takes time and experience and so I'm not hopeful that we can somehow make this the standard of care, but I sure would like to see at least all people who are providing care, um, have this as, in their toolkit, uh, trying to understand why these emotions exist and how they're normally regulated.

6. 23:15 – 31:57

   Dr Nesse’s Smoke Detector Principle

   1. CWChris Williamson23:15

      Go through some of the different reasons about why we have this type of response, smoke detector principle and the feedback loop and stuff like that. Let's run through that and then we can have a look at some individual emotions.

   2. RNRandy Nesse23:26

      (laughs) Yeah, I mean, the smoke detector principle I think may be my most practical contribution, uh, to psychiatry. I spent, you know, I was spending all my time helping to run the Anxiety Disorders Clinic at University of Michigan. George Curtis started it and he and I helped to develop it. We were one of the first anxiety clinics any place and after 10 years I realized, "Wait a second.Why does everybody have too much anxiety? It's not just my patients, it's me, it's everyone. Uh, and then I tried to figure out why telling people, um, that things weren't really dangerous didn't have any effect whatsoever. And my patients would go into a grocery store 10 times and have panic attacks 10 times. And I'd say, "You know it's safe." You know, I got frustrated sometimes, but then I started thinking, w- what's the cost of having a panic attack? What's the situation in which a panic attack is useful? And it, you know, that all ... n- I'm sure all of our listeners have had something like this at one time or another. You start suddenly feeling like your heart is pounding. You start getting short of breath. Your muscles tighten up. You feel like you're maybe going crazy and you've got to get out of there, wherever you are. So that is a perfect suite of things to get you out of life-threatening danger. Uh, Cannon, back in 1930, recognized this as a fight or flight response, a pre-programmed emergency response. So why would it go off when it's not needed? Let's think about the cost. Maybe 100 calories. But now you hear a sound behind a rock at the watering hole in Africa, and you have a stick instead of a iron spear. Um, should you run? Well, natural selection has shaped a mechanism, not just in us, but in every animal to do that calculation without any calculus, you know? And it depends on how likely is it there's a, there's a lion there. And what's the cost if you do run and he's there? Now, let's pretend you get away scot-free. What's the cost if you don't run and he's there? Let's pretend he just eats you. That's maybe 100,000 calories. Oh, wait, the ratio 100 to 100,000, that's 1,000 to 1. And if you do the math with what's called signal detection theory, uh, you realize that that means that you should flee whenever there's a probability of a lion being there greater than one in 1,000. And that means that 999 times out of 1,000, your panic attack will be useless, but normal. So that ... When I first did that, I couldn't believe my own calculation, you know. Um, but all of a sudden I realized, oh, wait a second, I've been misunderstanding this regulation mechanism in my patients all over the place. Now, my patient came out of the grocery store the 10th time still having panic attacks, and I was able to say, "Yep, that's the way the system is. Panic attacks are cheap. Uh, not having a panic attack with real danger is expensive. But for you, I suspect that what you're really afraid of is your own anxiety symptoms and they're ratcheting themselves up in a positive feedback cycle, a vicious cycle." And that too was really helpful for my patients 'cause they realized that they were afraid of their own symptoms, and their symptoms were causing anxiety, and anxiety was causing more symptoms, and off they were to the races. There were some patients who said, "Oh, thank you. That's all I needed. Now I understand, I'm out of here. Don't need to see you anymore." Um, more of them needed more behavior therapy or medications, I mean, we use whatever works. Um, but it was such a revelation to me to actually understand what the heck I was doing, uh, when I was treating people with panic disorder.

   3. CWChris Williamson26:52

      What about the consistent regrooving of particular sensations, particular thought patterns and emotional responses?

   4. RNRandy Nesse27:00

      Well, one, I'm not sure what, what you're getting at exactly, but there are also systems that reset the threshold for responding depending on your environment. So if every night you go to your watering hole and there's a lion there, it's really smart for the threshold to go down and for you to be much more sensitive and not to go any place near that unless you have a spear and three friends, and you can run home quickly and to have panic attacks go up. So this is fascinating though, because then the ... Having a bunch of panic attacks makes panic attacks more likely if it makes the environment seem dangerous. And that's what's ... So when I say that natural selection has left some of these systems intrinsically vulnerable to failure, this is a great example. And it's really good to have a system that readjusts the threshold for anxiety based on how dangerous your environment is. But that makes the whole system prone to go into a positive feedback spiral, and that leads to a genuine serious disorder.

   5. CWChris Williamson27:56

      But you don't get that consistent feedback spiral, it seems, towards positive effect. Now, maybe a little bit more confidence or a lack of fear, but as you mentioned earlier on, confidence begets competence, begets confidence, begets competence, and then you would have some person whose feet couldn't touch the ground for the next 30 years.

   6. RNRandy Nesse28:16

      Right. Right. Yeah. I mean, doing things repeatedly and moderately succeeding at them is good. Uh, we know s- ... We have treated so many hundreds of people with social fears, and it wasn't till I treated the first 100 that I realized that what they're afraid of is failing. They're not afraid of being in front of an audience, they're afraid of failing in front of an audience and, and doing something silly. So what's the right behavior therapy exercise for that? I'm sorry, you got to do something in front of an audience that's a failure, um, and, and making some mistakes. And being a podcaster like you are, I'm sure you're used to, "Hey, um, I made a mistake today and that's part of the game, you know, it just happens," and, and on, on we go instead of feeling too bad about it and worrying too much about it. Um, and there's a, a famous newscaster who's about to come out with his book, uh, about his struggles with anxiety-

   7. CWChris Williamson29:08

      Is it Dan Harden?

   8. RNRandy Nesse29:09

      ... and being on the air. No, someone else. I won't tell you his name yet.

   9. CWChris Williamson29:13

      Oh, okay.

   10. RNRandy Nesse29:13

       He's a meteorologist.

   11. CWChris Williamson29:13

       But didn't ... Sorry. Didn't, didn't Dan Harden do a book? Didn't ... Wasn't he the guy that had the panic attack live on air? Or he was one particular newscaster that had a panic attack and he did, uh, mm, it was a book about meditation, and this is five to 10 years ago.

   12. RNRandy Nesse29:31

       So th- so this, this is another one.

   13. CWChris Williamson29:32

       Okay.

   14. RNRandy Nesse29:32

       Uh, you know, you bring up this fact that we're in different circumstances now, this is a great example. And it used to be the biggest group you'd ever see in human society is 30 people. You'd be around a campfire, you'd say something stupid, and somebody would say, "What did you say?" And then you say, "Oh, I never said that. I didn't mean that." And you know, then it's over. Everybody's probably drunk anyway. Uh, nowadays, you, you say one wrong thing and it's recorded on podcast and you lose your job or you send the wrong tweet and it's the end of your career. Um, that's unprecedented.... mean, the amount of care and we're constantly monitoring ourselves saying, "Oh, be really careful you don't say that," which of course brings it to mind, right? And, and makes, makes it likely. Um, though I think, you know, we're all on camera or on microphone in ways that were unprecedented and that does create new pressures, uh, for self-control and, and that causes more anxiety and all the rest.

   15. CWChris Williamson30:24

       Everybody is-

   16. RNRandy Nesse30:25

       I think... D- did I touch a nerve there? But (laughs) ...

   17. CWChris Williamson30:27

       No, not at all. I, I, I-

   18. RNRandy Nesse30:29

       You gotta be so careful in your, in your job and...

   19. CWChris Williamson30:30

       It's, it's something that I've had to work through a lot because I'm very self-critical and I, throughout the show, you know, 530 iterations, 540 iterations of doing this thing and if I mess up, if I use the wrong reference, if I bumble one of my words, if my pronunciation and my diction isn't sufficiently precise, it will play on my mind once I finish up. And I think, "Oh, I must work on that. I must work on that. That was, that was not where I want to be. I should be better than that." And the anxiety that you get around not reaching that level is it, it, it does sit with you. However, I've found that drilling it over and over and over again, allowing that to sit with me and going, "Look, you... I overall I was happy with my performance. I think what, what were the contributing factors? Maybe I hadn't eaten particularly well that day. Maybe I wasn't sufficiently hydrated. I hadn't slept right. I hadn't trained on the morning, perhaps I hadn't prepared well enough for the guest," whatever. I've been able to move myself away from it being a label about me and who I am, and more into a assessment around my performance in the same way that an athlete might say, "Look, I, I, I didn't quite get there on the times today. We need to look at my nutrition, we need to look at my sleep, we need to look at my recovery." I really think that there's a lot to learn from treating our pursuits in life the same way that athletes do. They seem to be able to have-

   20. RNRandy Nesse31:50

       Yeah.

   21. CWChris Williamson31:50

       ... more distance. They understand that there are all of these contributing factors that create the performance, the outcome that comes

7. 31:57 – 38:39

   The Anxiety of Constant Surveillance

   1. CWChris Williamson31:57

      on that. Now, you... It was interesting what you said about, um, the fact that everybody's basically 140 characters away from losing their entire life-

   2. RNRandy Nesse32:04

      (laughs)

   3. CWChris Williamson32:05

      ... and career at every moment. And I had a conversation with a friend who's also a club promoter, which is my, uh, uh, how would you say, my upbringing as a, a businessman and we used to run a bar crawl event called Carnage in the UK. And people would buy a T-shirt. The T-shirt would be their ticket to the event, and you would go through five bars and then a super club at the end, and there would be tasks on the back of the T-shirt. You can tell this was before the Me Too and, uh, sort of social media era. It would be, um, got off with three randoms, pulled a pig, um, stole somebody's drink, like, just mischief stuff that people would get up to. But you would have 3,000 students a night doing this-

   4. RNRandy Nesse32:43

      (laughs)

   5. CWChris Williamson32:43

      ... moving from different venue to different venue and we would have this really wild orchestrated way of... 'Cause these venues would only hold 500 people until the last club so you'd have to move people in little groups and there'd be road crossings and we'd have stewards to stop the cars. It was wild. That, uh, lairy, louty style of very loose British behavior, which was quite common and still is in some circles, has been completely eroded, right, over the last decade and a half. It, it is-

   6. RNRandy Nesse33:16

      Mm-hmm.

   7. CWChris Williamson33:16

      ... so different. And I was having a conversation with a friend and he said, "Dude, you know what it is? I think that this panopticon that we've got where the sword of Damocles is hanging over everybody at every point, anything that you do, if you kiss the wrong guy or girl on a night out, previously, 15 years ago, that would have been passed around as rumor maybe between the people that could have-

   8. RNRandy Nesse33:39

      Mm-hmm.

   9. CWChris Williamson33:39

      ... said it to each other. Maybe they would have been able to text it around or something like that, but there wouldn't have been any photo evidence. You could have denied it." And after a while-

   10. RNRandy Nesse33:47

       Mm-hmm.

   11. CWChris Williamson33:47

       ... it's not instantiated in the multimedia 1080p way that now people are so much more concerned about the way that their behavior is going to be instantiated online for the rest of time. It is not surprising to me that that's the way that people feel.

   12. RNRandy Nesse34:04

       You know, it's a whole different world and we are ill-prepared for it evolutionarily. Um, I'm, I'm fascinated by the paradox that one thing that came with Freud and psychotherapy is the possibility of confidentiality. Um, pre- prior to that kind of thing, maybe your doctor would keep things confidential, but there wasn't this idea you could tell somebody all of your worst characteristics and, and have some confidence that they would keep them secret. Sometimes it doesn't work, but therapists are really good and I'm still not going to tell you about that TV anchor who has anxiety because, uh, he didn't give me permission. But I'll tell you afterwards because he's going to come out with a book that I think is, is pretty good. Um, so on the one hand, there's the ability to get into touch with your own deep, anti-social, and sexy and all kinds of feelings, uh, and wishes that you never would have told anybody, um, if there wasn't the promise of anonymity. And then conversely, especially with modern media, it's the exact opposite. Any tiny thing can be preserved forever. Um, and everybody can look at these poor political candidates. You can, (laughs) you can do a gotcha on anybody-

   13. CWChris Williamson35:11

       Yeah.

   14. RNRandy Nesse35:11

       ... uh, if you have enough tape.

   15. CWChris Williamson35:12

       Yeah.

   16. RNRandy Nesse35:13

       Um, yeah.

   17. CWChris Williamson35:13

       Yeah. Well, I mean, you see this, it, it's one of those, uh, byproducts, I suppose, that you, uh, go through time as somebody that puts things out on the internet. I mean, I'm sure that there's, there's papers or, or presentations that you've given that if the wrong section was clipped at the wrong time and then using-

   18. RNRandy Nesse35:32

       Oh, no, don't, don't go looking. Please don't go looking for-

   19. CWChris Williamson35:34

       Precisely. I know, I know.

   20. RNRandy Nesse35:35

       ...

   21. NANarrator35:36

       (laughs)

   22. CWChris Williamson35:36

       Um, but this is something that I have in the back of my mind. Up until now there's maybe, what, 1,000 hours perhaps, maybe 1,200 hours of content of me out on the internet and there's some things where I've put my foot in my mouth. As of yet, this is not a challenge to the internet. But as of yet, the, the smoking gun that unearths my secret bigoted patriarchal cis heteronormative superstructure, whatever it is that I do, that none of that's, uh, come about because as far as I can see, I don't believe any of the things that would be distasteful in that way.... but my point being, if you do anything for long enough, there is a nonzero chance that you do say something that's more than putting your foot in your mouth. Maybe it's your entire leg. And, uh, we ... There's no, um, extra allowance for people that speak more that gives them degrees of freedom to get away with saying different things. So let's say that somebody says ... does one video on the internet ever in their entire life, and somebody does 20,000 hours of content throughout their entire life. The person that does 20,000 hours-

   23. RNRandy Nesse36:40

       Mm-hmm.

   24. CWChris Williamson36:40

       ... of content is much more likely to say something. However, because you get to take things out of context, clip them and throw them on Twitter, that is taken-

   25. RNRandy Nesse36:49

       Mm-hmm.

   26. CWChris Williamson36:49

       ... completely in isolation. And look, I, I try my best. I just happen to have said the wrong thing at the wrong time. That's not something that people use as an excuse.

   27. RNRandy Nesse36:59

       So you were just saying, Chris, about the fact that you're actually a very careful person who reviews your performances and tries to figure out what went wrong and why it went wrong, just like another athlete might, might do. And I think that is the key to a lot of people really being successful, getting better and better at what they do. On the other hand, when we treated people with social phobias, I was mentioning that what they're really afraid of is somebody else, um, seeing them make a mistake. And so we, we have people so bad that they can't go into the grocery store because they're afraid of what the cashier's going to say or if they're gonna make a mess up when they try to sign their check. These are really serious disorders. And so one of our first exercises is to help them make mistakes on purpose and see how people respond. Our favorite one is to have them go into McDonald's and order a big ... a Whopper. And then we have them go into Burger King and order a Big Mac. And you know what happens if you do that? What happens is the guy says, "You don't mean a Whopper, man. You mean a Big Mac. You want a Big Mac?" And the guy says, "Oh, yeah, yeah." And so people realize when they make those mistakes that nobody cares, nobody remembers. And, and that's the kind of learning that you get. And there's no substitute for actually making mistakes. Now, if you're a professional musician and some- for the orchestra and you're trying out for something, you can't really afford, uh, to make very many mistakes like that. But Horowitz, you know, Horowitz was terrified by stage fright. His career was wrecked for quite a while 'cause he couldn't go out on stage. He thought he was going to make mistakes. And finally, he started making mistakes and doing it. Um, this perfectionism was still there, but you just have to accept we're all gonna make mistakes.

8. 38:39 – 42:49

   Causes of Low Mood & Depression

   1. RNRandy Nesse38:39

   2. CWChris Williamson38:39

      Getting into some of the emotions, what is the reason for us being able to feel low mood and depression?

   3. RNRandy Nesse38:49

      You know, the capacity for low mood exists because it's useful in certain situations. And the situations in which it's useful most generically are situations where you're spending a lot of effort trying to do something that isn't working. And if that's to happen ... I mean, Eric Clinger, who's a psychologist in Minnesota, wrote about this in 1975. I wish everybody could read his work. It's profound. And he pointed out that if something isn't working, the first thing you do is stop and quit wasting energy. The next thing you do is try to find a different way to your goal. Next thing you do is try again with a different strategy. And if you keep trying again with different strategies and nothing, nothing, nothing works, then the system actually turns off your motivation to keep pursuing that goal, and then you do something else. A woman named Jutta Heckhausen, a German researcher, moved to California, and she studied women who wanted to have babies, and they were approaching menopause. That's a bad circumstance, right? Now, people really, really want something, and they're not sure if they're gonna be able to get it. And I'm grossly, grossly simplifying her research, but one of the outcomes was that menopause happened for a lot of these women, and they weren't pregnant. Were they devastated the rest of their lives? No. Once the possibility was gone, for many of them, all of a sudden said, "Oh, wait, I can't have that anymore. That's unrealistic. I'm not gonna worry about that. In fact, why did I wanna have kids anyhow? They're very expensive. They're a nuisance." And then all of a sudden, once you take that goal away, I think I've cured more people by helping them to give up useless goals than I have helping them pursue goals. I ... When I was young, I kept on telling people, "Don't let the depression get in, in the way. Keep trying, keep trying. You've applied to graduate school four times. Try a fifth time." I realize I was young and naive and, you know, utterly, you know, insensitive to the real s- life situations of a lot of people. It's much better to try to realize, well, there must be good reasons why you have to keep trying to do something that isn't working very well. Could we talk about that? And are there other things you might wanna do in life, uh, other than this thing that is not going so well? And that kind of approach I found so much more helpful, uh, and more respectful of people instead of just encouraging them to keep trying or, or k- or give up. Um, it's just if people are stuck in a bad situation, I call them social traps, where you're pursuing something that you can't give up. Your, your mother tells you, "You have to go to become a doctor, or I won't love you anymore." At least she indicates that. No wonder you're trying and trying and trying to do that, um, but there might be alternatives, uh, for your life that'd be more satisfying.

   4. CWChris Williamson41:24

      How would this have shown up ancestrally?

   5. RNRandy Nesse41:28

      You know, good question, Chris. You know, I don't think people were doing as many long-term, big deal things way back when. There was no applying to medical school or PhD programs or trying to become a world-famous podcaster. Uh, there's, you know, there weren't things like that. That was trying to get nuts, uh, and trying to figure out whether it's wise to go out looking for them or not and trying to be helpful to other people in your group and become a leader of your group. But warfare, once there was agriculture and storage of things and, and hierarchies, and that's a whole different circumstance. But I think back in hunter-gatherer days, there weren't any such huge big deal things as the ones that we routinely encounter these days. When kids, you know, in college or not in college trying to figure out what to do with their lives ...... it's a tough road. I mean, I find the competition, especially to get into schools and stuff, I mean, it's ridiculous. It's so hard for kids to try to be the kind of person and portray it on paper that everybody wants to have in their college because you're smart and attractive and socially mor- motivated in all the right things. What a lot of pressure putting on everybody. And you can see why some people just bag out and say, you know, "Forget it. Uh, I'm not playing that game." It's perfectly understandable.

   6. CWChris Williamson42:48

      What

9. 42:49 – 50:26

   Why We Experience Social Anxiety

   1. CWChris Williamson42:49

      about, you've mentioned anxiety, which seems to be smoke detector principle, people erring on the side of negativity as opposed to positivity with things. What about social anxiety? Is that, that mapped across onto status and esteem in a group?

   2. RNRandy Nesse43:05

      So an interesting thing about social anxiety is that we all have it and we all seem to have too much. I mean, the criteria make it so that, you know, 5% of the population has it. But those are arbitrary. I mean, the majority of people are nervous about standing up in front of the group and, and saying something. And for the good reason that you might say the wrong thing or people might think badly about you, you know? The, the payoffs for saying something smart are not as great as the penalties for saying something dumb. And so it's, it's an anxiety provoking situation. But here's a question I started asking myself, why do we all care so much what other people think about us? And that goes back to a much deeper, more profound question about how the heck did we ever get these capacities for morality and guilt and committed relationships? And the, the arguments in evolution and evolutionary psychology about the origins of altruism and cooperation are long and remarkably nasty, uh, for people. I mean, getting people arguing about cooperation and goodness, and you see some of the nastiest tendencies in, in human, human life. It's very ironic. Um, but I finally found what I found to be a satisfying answers that Chris, and, and the work of Mary Jane West-Eberhard, an insect biologist who was trying to understand altruism way back in the 1970s. And, and her argument starts with sexual selection. You know, there are extreme traits, peacocks tails and that kind of thing because, hey, the female peacocks are choosing the male with the best tail. So those poor males have to drag around those long, dangerous, expensive tails to get the best mates. It's just how natural selection works. But the point, thing she pointed out is individuals are competing not just to be the best mates, but to be the best partner for other kind of things too. And I think that's, that's what has shaped our human capacities for sociality. That individuals who are preferred as partners, social partners by other people and invited to join the group, or invited to be buddies, or invited to do things or cooperate on things. People who are preferred as partners get huge advantages, even aside from sex. And we compete to be the kind of person that other people want to be with and want to cooperate with. And this creates really strong selection for being helpful and honest and empathic and a whole lot of other things that make people desirable. It creates its own selection force for being good. Uh, immediately when I talk about this, some people say, "Yeah, but people cheat all the time." Yeah, they do. Um, and know people who are trying to do the right thing often get taken advantage of. But that's just a price you pay, uh, for, for trying to do the right thing. And it's remarkable and wonderful that the vast majority of people basically try to be good most of the time. They're very sensitive to what other people think about them, and they, instead of going to bed thinking about, "How can I trick somebody into sleeping with me?" uh, they think, "Oh my God, did, did she misunderstand my intentions? And, and did she think badly about me because of the way I approached her?" I mean, people are so sensitive in trying to, um, make other people appreciate them. And, and just to wrap up this one more time, I find this hugely helpful because the, the crude ideas about, you know, we're all, you know, a bunch of selfish genes trying to replicate themselves as fast as possible. And I think that's a socially corrosive idea. And it's very hard for people to get beyond that simplistic kind of version to recognize how natural selection can shape us to have capacities for morality and commitment. Once you get that, I think it changes our view of evolution and human behavior pretty profoundly.

   3. CWChris Williamson46:49

      Would there not be an argument to be made that that is still selfishness acting in a selfish way? That altruism is you doing it in the hopes that you will be able to get something reciprorally- reciprocally down the line?

   4. RNRandy Nesse47:02

      But think for a minute about when, you know, somebody invites you over to dinner and you, you have a nice dinner there. And then after, um, you're leaving, you say to them, "That was a very nice dinner. I think it probably cost about $50 a person. Uh, I'm gonna invite you over to my house for a similar dinner or something." You know, that's not what we do. We don't want partners who are trading favors in simplistic ways. We want partners who love us, who care about us. Now, it's always a touchy business 'cause you don't want to get too out of balance, uh, with people. Uh, but, you know, John Tooby and Leda Cosmides are leaders in evolutionary psychology, and they talk about the banker's paradox. Um, you know, bankers are very eager to loan you money, uh, so long as you have a lot of money already and you have collateral. But when you don't have any collateral, they're not interested in loaning you a thing. What you want is somebody who will help you when there's no guarantee of a payback. When you're sick, when you don't have a job, when, when things are not going well. And the amazing thing is that that's possible for humans. Uh, a lot of us have real friends who care about us even when we can't do anything for them. Uh, some people don't believe that's possible. That there's a certain cynicism. And I think a cynicism that sometimes is generated by evolutionary psychology, that everybody's out for themselves some level always. Uh, not really. I mean, I think social selection shapes...... capacities for genuine altruism and genuine morality. And of course, it's not present in everybody, um, and there's a lot of cultural differences and you have to be careful. I mean, the people who really overdo it are Bernie Madoff types, right? Generous to everybody until you find out that the whole damn thing has been a fraud for decades.

   5. CWChris Williamson48:44

      Where I see or where it amazes me the most that, uh, humans are able to coordinate in the way that they do without anybody actually forcing anything on top of them is on the London Underground. So if you've ever been there, you'll see that there are these-

   6. RNRandy Nesse48:59

      Hmm.

   7. CWChris Williamson48:59

      ... trains going past at unbelievable speeds, even the ones that are pulling in to slow down. And all of these people are stood within a couple of yards of certain death. Nobody pushes anybody over. No one.

   8. RNRandy Nesse49:13

      Right.

   9. CWChris Williamson49:13

      No one decides to do it.

   10. RNRandy Nesse49:14

       But it, but it's nothing compared to Shinjuku in, in Japan. If you go to Tokyo and you see people in their subways, they line up in a perfect line, the right number of people for each car and file in, in an orderly way. It's astounding. And it makes the Brits queues look disorganized.

   11. CWChris Williamson49:33

       Look, we-

   12. RNRandy Nesse49:33

       And then you go to certain other places-

   13. CWChris Williamson49:34

       ... we are proud of our queues, Randy. I will, I will not have you besmirch the good nation of Great Britain's ability to stand in a line behind each other.

   14. RNRandy Nesse49:43

       I, I was gonna talk about New York City. It's different there.

   15. CWChris Williamson49:47

       Good. Yeah. Good. Talk about the, talk about the bad ones.

   16. RNRandy Nesse49:50

       (laughs) There have been... And this brings us to culture, Chris. I mean, th- cultures vary dramatically and what works in one culture does not necessarily work well in other cultures. And we adapt ourselves quite nicely. Um, when I get into a taxi cab, you know, around where I live in rural Michigan, I'm always nice to the guy and give him a nice tip. And I know he is gonna take me the most direct route 'cause if he doesn't, I'll tell somebody. Uh, I get in a taxi cab in New York City and I put in my GPS to see if he's taking me a roundabout way. And I, you know, it's, it's just a whole different, different culture.

10. 50:26 – 1:01:39

    Ancestral Causes of ADHD

    1. CWChris Williamson50:26

       What about ADHD? What is the ancestral reason that we would have developed the capacity for this to, uh, be a phenomenon?

    2. RNRandy Nesse50:37

       (inhales deeply) So I just wrote a chapter for a book that's coming out next week about evolutionary psychiatry. Um, I think 27 chapters, it'll be definitive for some time. You might find some really good people to talk with, uh, in, in that, in that book. It's the first big edited volume, and it's done by people from the Royal College of Psychiatry. I mean, I've spent my whole career trying to develop this field, and it's thrilling to see it finally come through fruition, uh, this way. Um, but my, my chapter, um, starts off by saying that the biggest mistake you'd make in this field is trying to assume that a disorder is an adaptation and has some function and exists for some reason. I think that's a terrible mistake. And ADHD was not shaped by natural selection. There is variation among people in their degree to which their attention stays focused or wanders. And natural selection certainly has left us with some, you know, breadth of that. It's not like we all have the exact same, you know, tendency to attend to things for 10 minutes or no longer. Some people can focus for hours, other people, you know, 15 seconds. Um, the main explanation for that, in my view, is that in ancestral environments, it didn't matter that much whether you could focus for a long time or not. Another answer, going back to ancestral times, is that there are different strategies for getting your food. One is to focus in one spot and just sit there waiting, hunting, and another is to wander all over the place trying to find food. You know, this happens even for fruit fly larva. Have you ever heard that story? There, there are two kinds of fruit fly larva. There are rovers and sitters. Uh, some of them sit just about in the same place and they gobble up all the food right next to them. Others rove all around, uh, trying to find food in different places. And this is, these are hunting strategies in general. I mean, some hunters stay still in the woods and other hunters roam around in the woods. And these are both viable ways of trying to find things.

    3. CWChris Williamson52:37

       I'm gonna guess that when you are in a tribe and the tribe is pooling its resources, you're not just going to eat for yourself, you're going to eat for yourself and your family and maybe some of your friends' families as well. That means that if you, Randy, happen to be the ADHD, uh, predisposition version of you and you are going all over the place and I'm doing a different strategy, we get to spread the risk of this. While maybe the actual-

    4. RNRandy Nesse53:06

       Right.

    5. CWChris Williamson53:07

       ... th- uh, this particular season, there are only a very small number of bushes, but these bushes have tons of berries on, I win. Another season, they might be spread a little bit more, you win. Overall, by smearing this across a population level, you end up being able to hedge people's risk in a much more effective way.

    6. RNRandy Nesse53:24

       Very right. Um, if in fact these people are relatives who share a lot of your genes, that works perfectly well. Even if they're not your relatives, if you can guarantee that everybody's gonna equally share the resources, that also works very well. But if, um, whoever gets the most keeps the most, and one strategy works better than the other consistently, then that strategy is gonna go away. Um, the idea that natural selection can shape traits that benefit the group at a cost to the individual just doesn't work. It seems like it works, it seems like it should work. Uh, but George Williams, my co-author for developing the field of evolutionary medicine, pointed out to everyone's surprise back in 1966 that, you know, traits that make individuals sacrifice for the good of the group can't persist because if some individuals do more for the good of the group at their own expense and have fewer offspring, those genes are gonna be selected out pretty quickly. Now, the follow-up from that, as I'm sure you're aware, is that Bill Hamilton just about the same time, the wonderful British biologist, recognized that you can do things that decrease your own reproduction even-... and that can still be selected for so long as there are benefits to relatives who have the exact same genes as you do, including those genes for cooperation.

    7. CWChris Williamson54:44

       What's an example of that?

    8. RNRandy Nesse54:47

       Um, actually the anecdote that one has to tell when talking about this is from the famous socialist biologist J.B.S. Haldane, uh, back in the '40s. Uh, someone asked him at a pub, "Uh, would you sacrifice your life for your brother?" And he says, "No, I don't think I would. But I would for two brothers or for eight cousins." And that really says it better than any fancy math I could do. Um, but this idea that you can, um, ensure that, um, everybody in the group pulls for the good of the group even at their personal cost doesn't work in general. Now human societies, we should note, are different than that 'cause, you know, we organize groups on purpose to do stuff. More than that, there are leaders of groups who often are trying to exploit, not necessarily on purpose, but they're trying to get the group to do what's good for the group. And by the way, the CEO of the corporation gets rich off it, um, by encouraging cooperation and enforcing cooperation. Some of my favorite work on this, um, is by, uh, uh, let's see, Arvid Ågren, uh, has done some of it and Kevin Foster at Oxford, and they do work on cooperation in bacteria. Bacteria cooperating, even different species of bacteria? They can do it, but the key to them doing it is that they do things that enforce the cooperation without a cost. And I think that is going to be the principle that, that really turns this behavioral ecology of cooperation into a more sophisticated science. If there can be costless enforcement, um, that leads to remarkably, um, pro-social traits. So it-

    9. CWChris Williamson56:27

       What, what's an example of that?

    10. RNRandy Nesse56:30

        Well, if you, um, if you see somebody throwing junk out of their car and you call them on it and you say, "Hey, why are you throwing junk out of your car?" they might pull a gun on you. So, that is not costless enforcement. Um, if you can anonymously text somebody and say, "This, this yahoo is throwing junk out of their car. Uh, please stop them from doing it." That's, that's costless enforcement. Um, but really, in every day and every way, we do costless enforcement. And the easiest way to do costless enforcement is when somebody starts talking nonsense, you just say, "Oh, thanks. Uh, I guess that's intere-" and then you walk away. You, you, what we mostly do with people who are saying stupid stuff is just ignore them and that works very well.

    11. CWChris Williamson57:11

        So, we vote with our attention.

    12. RNRandy Nesse57:14

        Yeah, yeah. And p- what people hate most, of course, is b- not being paid attention to, um, and that's for good reason.

    13. CWChris Williamson57:21

        I've just thought there, we were talking about how, um, multiple different types of attention level smeared across an entire tribe could be useful because it provides people with varieties of strategies to the same problem.

    14. RNRandy Nesse57:36

        Right.

    15. CWChris Williamson57:37

        It seems ... Am I right in thinking that ADHD now, in the modern world, especially for young boys and, and men that are going through the education system, is a particular problem because there is one very specific type of challenge-

    16. RNRandy Nesse57:52

        Mm-hmm.

    17. CWChris Williamson57:53

        ... that they are facing, therefore a multiplicity of approaches in terms of their ability to... Attention is one of the key resources that they need and somebody that has a higher-

    18. RNRandy Nesse58:02

        Mm-hmm.

    19. CWChris Williamson58:02

        ... degree of intention is alwa- a- attention is always going to be in a better situation, which means that this smearing, this range that we have is actually a disadvantage for anybody that's below the, well, anybody that's not at the 100th percentile, but anybody that's below the 50th percentile is at a disadvantage.

    20. RNRandy Nesse58:19

        (laughs) I mean, this, this whole idea you're supposed to sit in a chair for hours and learn stuff, I mean, is hopeless. Um, I can't, w- it's torture for me (laughs) and for a lot of kids. It's just, it's just, uh-

    21. CWChris Williamson58:28

        Says the professional academic of many decades.

    22. RNRandy Nesse58:32

        You know, I, my attention span is pretty short, Chris, and you know, I keep shifting from, you know, I've written papers on evolution and anxiety and cancer and all kinds of other things. You're not supposed to do that, you know? You're supposed to just do one thing and keep a focus and I've been incapable of doing that. Unfortunately, I've mostly gotten away with it. But there's something else interesting about ADHD that I've recently thought about but not written about, and that is the drugs that you, that work on it. I mean, they're basically amphetamines. Amphetamines increase focus. So, what else we know about amphetamines? Well, they're stimulating the dopaminergic system, the reward system in the brain. And in fact, if you're out foraging and you're looking for something and you're looking for berries, um, every time you find a big patch of berries, that dopamine goes off. And that dopamine gets you to keep doing whatever you're doing because it's paying off very well. And when the payoff fades, uh, you move to the next bush and you start looking for... And all organisms are shaped to stay at the right length of time at a foraging patch and move on to the next one at the right time to optimize their number of berries or calories they get per hour. And it seems to me that again, there are different foraging strategies. Um, getting every single berry off the bush, not the best strategy. Getting the first handful off the bush and looking for another bush, not the best strategy. But there's a long way in between of trying to figure that out, and these dopaminergic systems adjust how long you stay at that bush, leading me to the project maybe some listener from this podcast will take up, I wish somebody had done this long ago, um, I'd like to turn loose kids with a genetic predisposition to ADHD, um, and a lot of other kids in a field picking raspberries and watch what they do. Do the ones who pick raspberries who have ADHD go more quickly from one bush to the next bush? Is it a foraging strategy? I bet it is. And this would also lead to tests for ADHD where you could have kids do foraging on a computer screen and see if they jump too quickly from one patch to the next patch, um, and it's, and also whether they can adjust as the patch density changes.Um, and these are very sophisticated mechanisms, not just in us but, I mean, bumblebees do it very, very well. Um, they fly to different flowers and try to assess whether this flower is worth it. And as the day gets cooler and it costs more energy to forage and the flowers are not having as much nectar, they turn off their foraging and go home at just the right time. And those that stay too long or those that don't stay out long enough, they don't do as well. And this is very much like, I mean, there would be ADHD in bumblebees or too much focus in bumblebees. No- nobody focuses on the people who focus too much. In every single one of these disorders, you can have too much or too little. And this is another implication of an evolutionary view that we should be recognizing. There can be too much and too little anxiety. There can be too little low mood as well as too much low mood. And foraging-

    23. CWChris Williamson1:01:38

        What would,

11. 1:01:39 – 1:07:51

    The Danger of Low Anxiety

    1. CWChris Williamson1:01:39

       what would, what would too much, uh, sorry, what would too little low mood and too little anxiety be like? What would that sort of person be like? What would the dangers be?

    2. RNRandy Nesse1:01:47

       Well, too little anxiety is pretty obvious, and Isaac Mercer called, and I have called, this hypophobia. Uh, these are people who are, have a life-threatening disorder. I mean, on the edge of the Grand Canyon, and, and you know there's one group of us who's likely to have this more than the other. I mean, twice as many men as women fall into the Grand Canyon every year, um, and it's no accident. It's 'cause men do wild and crazy and, and risky things. And this is another insight that came from evolutionary thinking. It was very helpful to me in the clinic and then talking in general. And now maybe I'm gonna say one of those things that gets me in trouble, Chris. So-

    3. CWChris Williamson1:02:23

       I hope so.

    4. RNRandy Nesse1:02:23

       ... you can see maybe I can... You can edit it out if I get myself in too much trouble. But I get asked often, "Why do women have more anxiety than men?" A lot of people ask, "Well, it might just be our culture or it might be the patriarchy or, or something." Actually, um, male rats and chimpanzees and all kinds of organisms take more risks and they die young. And the answer is that they're competing and, and doing competitive kind of stuff. Um, but why do women have more anxiety? Is there something wrong with them? And here's the insight. No, uh, women have just about the right amount of anxiety. Thank you. Uh, men do not have enough anxiety 'cause natural selection has shaped them to take more risks because that has, in the past, given a reproductive payoff on average.

    5. CWChris Williamson1:03:11

       I had Roy Baumeister on the show, and he did a study about men crossing a busy road at a crossing before the light went green for them to go over, and the difference in the distance from the most, the closest car to them in the presence-

    6. RNRandy Nesse1:03:30

       Right.

    7. CWChris Williamson1:03:30

       ... of women or without the presence of women. And the difference, (laughs) the difference when there's women around for risk-taking behavior just goes through the roof, obviously. And, uh, it's just, it's so blatant and, and obvious. Um, did I hear you once say-

    8. RNRandy Nesse1:03:45

       So, so pardon me. W- women could fix this, right? If they, if they-

    9. CWChris Williamson1:03:48

       Just stay away.

    10. RNRandy Nesse1:03:48

        ... didn't appreciate guys who-

    11. CWChris Williamson1:03:49

        Just... Oh, right. Okay. I would just don't, don't try and cross the road.

    12. RNRandy Nesse1:03:53

        Well, no, don't have sex with wild and crazy risk-taking guys. That would solve the problem for the whole species.

    13. CWChris Williamson1:03:57

        Well, the problem there is that's-

    14. RNRandy Nesse1:03:59

        That's what women are attracted to, right? That's what they want. Yeah. Well, that, that's too great a generalization, but we'll go back to the simple thing. Um, women do not have no, excess anxiety. I think on the average women have the right amount of anxiety, and men have, on the average, hypophobia, which is where we were a minute ago. They don't have enough anxiety for their own good.

    15. CWChris Williamson1:04:23

        Yeah. I, um, I find the, uh, differences between the sexes in terms of their, uh, mental makeup fascinating. Did I hear you say that by the age of 20 for every 100 women that had died, 300 men had died?

    16. RNRandy Nesse1:04:43

        So this came from a project that Dan Kruger helped me with at University of Michigan. And I, there I was making up one of my lectures on evolutionary medicine one time, and I was pretty sure that men had higher mortality rates than women 'cause I'd just been visiting my grandparents in, in the, you know, retirement community and, and the tables were all women. There were, there were no men. And so I wanted to figure out so exactly how many years less life do men have than women? I thought seven years, eight years. I couldn't find that number. But what I did find is the World Health Organization database on mortality rates by age, by sex, by culture, and by decade going back 100 years. It was gold. So Axel and I spent the summer in the basement analyzing that, and I realized the right way to analyze that was not just to analyze the, you know, mortality rates, it was to analyze the ratio of mortality rates between men and women. And the question I asked myself starting this off is, for every 100 men aged age 20 who die this year in the United States, how many women are, how many... for every 100 women who die, how many men are gonna die? And I thought, "Well, you know, men do some wild and crazy things. Maybe it's 120 men." Then I looked at the data, Chris. It was 300 men. And it wasn't just the USA. It was present in all of 20 countries that we studied. And even before puberty, um, male mortality rates are 50% higher for men than women, and the rate is still higher up until age 80. And it's also present for 19 out of 20 leading causes of death. Alzheimer's disease is the only one that claims more, um, women than men. So what do we have here? First of all, a quick caveat. It's not as simple as natural selection, uh, shaping sexual competition between men. There are some very interesting chromosomal things involved that may be relevant, um, and there are profound cultural variations as well. We did another co- study looking at perestroika and what happened in Russia when things opened up. And, and what happened is male mortality rates went up to five times higher-Um, there's probably a simple answer to that and that's cheap vodka, um, which is not, not as dramatic as, as something else. But, but the big principle here is, uh, that, like you say, men and women are different in ways that affect their health profoundly.

    17. CWChris Williamson1:07:05

        The chromosomal pin- thing that you're talking about there, is that men are nature's play things? Is that that theory, that men are less costly to have genetic traits being played around with, and s- many of them fail, and some of them are good?

    18. RNRandy Nesse1:07:23

        No. It refers more generally to the fact that women have two X chromosomes, and so if a gene is missing on one of them, they're still okay, uh, while men have only one X chromosome, which is why color-blindness is much more common in men, uh, than women. Uh, it's just because, you know, you don't have a backup copy of a gene if you're a man. Again, what I'm just saying is grossly simplified, uh, because there, there are certain backups and, and it's very complicated genetically, but that's the general idea.

12. 1:07:51 – 1:12:31

    Did Evolution Cause Eating Disorders?

    1. RNRandy Nesse1:07:52

    2. CWChris Williamson1:07:52

       Ancestrally, why would we be given the ability to have an eating disorder, something like anorexia or bulimia or...

    3. RNRandy Nesse1:08:02

       So, it almost sounds like you're making the big mistake right there, Chris, um, of trying to say that there's an evolutionary reason for eating disorders as an adaptation. And some people have said that. Some people have said eating disorders are actually a strategy, uh, for getting mates or for regulating your reproduction or something. Um-

    4. CWChris Williamson1:08:19

       I'd, I'd heard the second one. I'd heard the reproductive cycle, like basically, uh, how would you say, primitive birth control.

    5. RNRandy Nesse1:08:28

       Yeah. Michelle Serby wrote about that back almost 30 years ago, and at the time it was, well th- these, this is where we all started in trying to understand mental problems from an evolutionary point of view. And I'm trying very hard now to get people to not try to figure out what's the adaptive value of eating disorders, I'm trying to help them to back up to say, "What are the universal traits we all share that make us all vulnerable to eating disorders?" And now I think I can make quite a good case with those. Uh, characteristic number one is, we really want to be attractive to the opposite sex, especially at puberty. And two, uh, we care about our partners and what they look like. And there are peculiarities in modern cultures where everybody's trying to emulate some ideal from, you know, media a- and the like, which makes it all the more extreme. The next thing is that we believe we can control our behavior just by deciding to. And I think free will and the belief in free will is a big contributor to eating disorders, 'cause people think that they can just stop eating for a few days and lose weight. It never works. Uh, there's another thing that natural selection is built in, which is a, a famine protection mechanism. So, if you just stop eating for a few days, uh, as far as your body knows, you're starving, and it gets you to do what you're supposed to do during starvation, which is find food, as much food as you can, and eat it all at once. That's called binging. And when some poor person who's trying to lose weight and doesn't eat for a couple of days suddenly finds themselves staring at a whole loaf of bread that they ate or an empty gallon of ice cream, they get terrified, 'cause they have in fact lost control and they get frightened they're gonna lose control again. Not only that, if you keep doing that, the body resets its weight set point up a little bit. Because if you're in, in an environment where the food is erratically available, it's good to put on a few extra pounds. So paradoxically, uh, this attempt to lose weight ends up with gorging and gaining weight, which again sets into process one of these positive feedback cycles. The more you try to stop eating, the more you binge, the more you get frightened, the more you gain weight, the more you try to diet, and on and on it goes. Again, I'm gonna pause and say it's not as simple as this. And not everybody who diets, some people diet successfully and do not get into binging episodes. Other people, um, I mean, it's not nearly that, that simple. Um, and there are, a whole separate kind of question is why some people get eating disorders and others do not. Um, uh, one of the leading psychiatrists in evolutionary psychiatry is Riad Abed. He's one of the editors of this book coming out, and he emphasizes, uh, that eating disorders are more common in modern cultures and ones with big media presences because people get unrealistic ideas about idealized bodies and they go out trying to emulate them, um, in order to do mate competition kind of things. I think that's basically right. But it doesn't lead to, that leads to dieting, and you have to combine it with these other things I've mentioned to get into the positive feedback cycle that leads to eating disorders. But notice how completely different this is than the usual approach. The usual approach says, "What's wrong with this eating disordered person's genes? What's wrong with their early life? What's wrong with their pattern of thinking? What's wrong with their brain?" Um, a lot of work on genetics of eating disorders in recent years, and they've actually found eight loci on the genome that influence your risk of eating disorders. And if you put those together with even those that aren't statistically significant, you can explain some of the variance about who gets eating disorders and who doesn't. All together, all the genes, put them all together, you can explain 1.7% of the variation. What? We're spending tens of millions of dollars to explain that and trying to blame eating disorders on bad genes? I'm sorry. That's nonsense. Uh, we need to be trying to understand these disorders in terms of the mechanism shaped by natural selection and why they're vulnerable, uh, to malfunctioning.

13. 1:12:31 – 1:17:25

    Genetic Existence of Schizophrenia & Bipolar

    1. RNRandy Nesse1:12:31

    2. CWChris Williamson1:12:31

       What about schizophrenia and bipolar? This is something that I'm seeing especially on TikTok talked about a lot more at the moment. It seems a little bit like a social contagion of self-, uh, how would you say, uh, self-diagnosis. Um, but w- why do those come about? Why are they even something that exists?

    3. RNRandy Nesse1:12:54

       ... and the right way to ask that is why did the genes that cause those disorders persist. Um, and it remains a mystery, Chris. Um, I mean, this is something I've been very interested in the last chapter of my book. And I have a big article in Psychology Today suggesting some speculations of mine about this. Um, there has been a lot of speculation in evolutionary psychology about maybe schizophrenia is somehow beneficial, or maybe the relatives of schizophrenics are shamans and they stay home with the village and they get extra matings or something like that. And that's balderdash. You know, schizophrenia is a really severe brain disease and, and, no, that, that's irresponsible, I think, to be going on like that. But it is the fact that on the average, schizophrenic men has, have half as many children as other people. Schizophrenic women also about 20 or 30% lower. That level of fitness should select against any genes for that disorder really strongly, really fast. So you have to ask and say, "Well, why the hell are they persisting in the genome?" And it's very tempting for people to say, "They must be doing something good." Um, I don't think so. I think the most likely explanation is mutation selection balance. Mutations happen. Uh, they're only gradually selected out. The process of brain development is very touchy and any little kind of thing can make it go wrong. But here's the question I think has not been asked enough, Chris. Why does it go wrong in that particular way?

    4. CWChris Williamson1:14:21

       Consistently.

    5. RNRandy Nesse1:14:22

       Why... Yeah, why, why does it end up with, with, you know, auditory and visual... of auditory hallucinations of voices? Why does it go wrong in a way that you p- think everything, everybody's looking at you? Why does it go wrong in a way that, that people, you know, um, imagine they can read other people's minds and other people re- ... And that, and that says something about the design of the mind. Um, it's kind of like... This is gonna sound really crude, but, you know, your auto engine has certain ways of going wrong. You, you can get a knock if you use the wrong octane gasoline. You can, you know... Things go wrong because of the nature of the engine, but... And I think that's the way we should be trying to understand these dire diseases, that there's, there's something intrinsically vulnerable about the information processing system of the mind that makes it vulnerable to going wrong in that particular way. But now you're gonna ask me to say what I mean by that exactly. And, you know, I don't think it's gonna turn out to be anything simple. Uh, I have speculated that maybe natural selection has pushed the system to a performance peak because of the great advantage of the social abilities and language abilities and intelligence just in the last couple 100,000 years. And my other new idea along these lines is that we should be talking about, um, the similarity between these kind of problems and all the problems that resulted because we stand upright. You may be aware that we got all kinds of problems because we walk upright. We have varicose veins, we have hemorrhoids, we have hernias, we have bad ankles, we have bad backs, we have... I mean, there's all these things that go wrong because standing upright, uh, we're adapting to it gradually evolutionarily. But natural selection has not been able to fix everything because it's slow and because not all these things go wrong for all of us. Um, I'm giving this a new name actually. I'm calling these things re- uh, wrenching transitions. And the transition to walking upright is a, is a wrenching major transition 'cause it changes all kinds of things. And when you try to fix one of them, it's liable to screw up another one in the process of making that transition.

    6. CWChris Williamson1:16:44

       Right.

    7. RNRandy Nesse1:16:44

       And my speculation is that the wrenching transition, uh, from a previous kind of social life to the cultural and social, um, um, ecosystem that we live in for the last 100,000 years, that that transition is a wrenching transition for the information processing system of the brain. And it ends up with something's getting fixed, kind of like your hemorrhoids get fixed or your varicose veins, they get fixed at the cost of something else, uh, leaving us vulnerable. But I'm gonna emphasize once again, this is just trying to make some sense out of something that is so tragic. Um, and it's, it's very hard to understand.

14. 1:17:25 – 1:19:28

    Is Modernisation to Blame for Mental Illness?

    1. RNRandy Nesse1:17:25

    2. CWChris Williamson1:17:25

       When it comes to depression, anxiety, bipolar, schizophrenia, social anxiety, all of the things that we've gone through, how much of this do you think can be laid at the feet of the modern world, and how much of this is over-diagnosing and moral panic? Uh, human nature hasn't changed particularly much over the last 10,000 years. So-

    3. RNRandy Nesse1:17:47

       Mm-hmm.

    4. CWChris Williamson1:17:48

       ... were we as anxious and depressed and full of ADHD, uh, when we began the Agricultural Revolution?

    5. RNRandy Nesse1:17:58

       Or a different way of asking it. Uh, are the disorders equally present back then? And would things like ADHD even cause much harm way back then? Um, and ADHD in particular is something that, you know, probably was just a variation, didn't hurt you much, uh, back then. I do think people have always been prone to some bad depression and bipolar and schizophrenia and autism. And I'm not at all sure that those things... I think it's actually quite unlikely that those things are vastly more common in modern life. Um, I think those are more intrinsic vulnerabilities, both genetically and because of the kind of feedback things that we- we've talked about. But it's really disappointing that we don't have good data about this. Um, and there's good reasons for it. I keep encouraging people, anthropologists to, to go and gather data. But how many people do you need to study to figure out what the rate of schizophrenia is? Um, a couple thousands.... and you need sophisticated diagnostic things. Hunter-gatherer tribes are 30 or 50 or 100 people. Um, you really can't do it very well. There are good field reports of people who have things that look very much like schizophrenia in hunter-gatherer bands, some about bipolar disease an, uh, um, OCD as well. But this is an area where, um, we continue to do gigantic billion-dollar studies in modern societies. And investing even a pittance of that to study hunter-gatherer mental health, uh, would pay off big-time.

Episode duration: 1:24:09