You can tell an academic discipline is in its infancy when there are ten times as many names for it as there are graduate programs dedicated to its study. Such is the case with evolutionary clinical psychology…or should that be clinical evolutionary psychology? This burgeoning new field, in addition to having a plethora of monikers, consists of many theoretical approaches — each looking at evolutionary clinical phenomena from different angles — which will hopefully be integrated one day into a cohesive whole: evolutionary psychopathology! Or maybe it should be called evolutionary psychiatry….
If my hand had three additional fingers, I could count on one hand the number of individuals I’ve spoken to who are specifically interested in evolutionary approaches to clinical psychology. Yet, there are hundreds of researchers who have published articles that could fall under the banner of Darwinian psychiatry…or Darwinian psychopathology, if you prefer (okay, almost nobody calls it “Darwinian psychopathology,” and it’s probably best if we keep it that way, considering the current glut of labels). Research in this field, rich in its potential to explain and help treat some of humanity’s most intractable problems, is growing steadily but still relatively rare; quite new yet as old as the discovery of evolution itself. I’ll show you what I mean.
Not long after Darwin published Origin, he was already applying his new theory to clinical psychology and the emotions (as in his 1872 book The Expression of the Emotions in Man and Animals). Following in his stead, generations of Social Darwinists and eugenicists viewed “insanity” as resulting from feeble genes that should be fished out of the gene pool and discarded via coerced selective breeding and sterilization; that wasn’t quite what Darwin had in mind, but one can only assume they meant well.
Evolutionary approaches to psychiatry next appeared in the work of Freud and Jung. Although a great many of his ideas are now seen as directly contradictory to evolutionary theory (I’m looking at you, Oedipal Complex), Freud was quite evolution-minded in the formation of his psychosexual stages, complexes, defense mechanisms, and the rest. Carl Jung likewise was an evolutionist, and this can be seen in his concept of “archetypes,” inborn mental concepts which he viewed as evolved psychological “organs” present in all humans from birth. If this sounds a lot like the mental modules posited by cognitive evolutionary psychology, well, it’s not – the archetypes weren’t considered to be functionally specific in the same way that modules are, and they had fantastic names like the Animus and the Shadow – but in positing universal, evolved mental organs (as opposed to conceiving of the mind as a blank slate), Jung was somewhat ahead of his time.
By the time Jung was old, Behaviorism had become the dominant paradigm in the field of psychology, and so animal models were all the rage. After several decades of watching non-human animals do funny things in cages, researchers were ready to try to reintroduce evolution and clinical psychology. Ethological Psychiatry: Psychopathology in the Context of Evolutionary Biology by McGuire & Fairbanks (1977) was the result. This movement was the most rigorous attempt yet at understanding human psychopathology from an evolutionary perspective; behaviors were observed in animals that were analogous to conditions like depression, generalized anxiety, obsessive-compulsive disorder, and so on. This allowed researchers to extrapolate to humans and theorize that we shared some of these neural pathways with our non-human cousins, and that our mental illnesses might best be conceptualized as etiologically similar to theirs.
While this enlightening work was being done in animal labs all around the world, therapists were also incorporating evolutionary thought into their treatments, with varying degrees of success, in more direct ways than Freud and Jung had. These efforts ranged from quaint references to the “triune brain” to more modern and stringent attempts examine patients’ clinical issues from an integrated evolutionary context, as in the excellent and oft-overlooked Exiles from Eden: Psychotherapy from an Evolutionary Perspective by Glantz and Pearce (1989). These perspectives (known as evolutionary psychotherapy, sociobiological psychiatry, clinical sociobiology, or any of the other labels floating around these paragraphs) are subject to interpretation by individual practitioners, but generally involve implicitly or explicitly comparing patients’ behavior to the normative set of behaviors that our hunter gatherer ancestors would have engaged in. A therapist utilizing this approach might, for example, validate a husband’s sexual jealousy by emphasizing its biological utility, in attempts to help him overcome it. For more information, see the Psychology Today blog Neanderthink by Nando Pelusi, a clinician who uses evolutionary perspectives in his practice.
And that leads us to the modern era of – let’s call it evolutionary clinical psychology, which is sufficiently descriptive, inclusive (not all of these perspectives utilize Darwinian selection, for example), and sidesteps whatever controversy may surface through the use of the word “sociobiology.” (As an aside, it seems that many in the younger generation of evolutionists, to which I belong, are puzzled yet intrigued by the pervasive insinuations that some very dark Incident happened with the field of sociobiology, something unspeakable which has tainted the word to this day. To us, sociobiology is the foundation of evolutionary psychology, and to even hear that there is controversy surrounding it seems, somehow, quaint and a little bit spooky.)
The current discipline, in its most inclusive construal, exists at the junction between evolutionary psychology and evolutionary medicine, and includes all of the approaches mentioned above (with the general exception of some of the dustier psychodynamic theories). Taken as a whole, the breadth of literature within the modern field of evolutionary clinical psychology seeks to understand, classify, and treat mental disorders and other clinical phenomenon using the tools and perspectives of evolution: adaptation, function, natural selection, mutation, genetic drift, phylogeny, mismatch theory, and so on.
It is this “writ large” definition of evolutionary clinical psychology that will be the focus (or lack thereof) of this blog. Bookmark me, and check back often!
Thank you, Daniel, for writing this thought-provoking post. I’m currently a 3rd year undergraduate psychology major at UCLA with a brief, but formative, research background in evolutionary psychology. At the present I’m interning in various labs that study adult and child psychopathology, as well as pursuing evolutionary medicine as a minor. My goal is to apply to clinical Ph.D. programs, and I find the prospect of doing research in the field you’ve outlined above, clinical evolutionary psychology, to be very enticing. Do you have any advice for somebody in my position? More specifically, do you know of any prominent researchers that I should consider applying to work with? Thanks!
Pingback: Creativity, A Silver Lining to Mental Illness
Pingback: The Relationship of Evolutionary Psychopathology to Evolutionary Psychology | Welcome to the EvoS Consortium!
Rose, that is an excellent question and one on which I am ill-qualified to remark, at this stage in my learning. A response to this could be a blog post in an of itself (or a whole book even), but short answer, I do think elements of an individualized approach are necessary in clinical psychology, just as in the field of medicine, rather than a cookie-cutter approach to treating disorder, regardless of individual circumstance. I will say that a strongly custom-fit approach might be more appropriate and feasible for counseling and psychotherapy settings than it is for severe mental illnesses such as schizophrenia or OCD, which seem very conducive to biomedical approaches as well as other forms of therapy. The lifetime prevalence rates of such disorders (1-3%, as you mention) aren’t really so rare compared to other types of illness–around the same rates as asthma in the US, for example–that unified approaches are untenable or undesirable. Patient-centered biopsychosocial approaches to treating asthma tend to be more effective, but in terms of etiology and research, there is still plenty of room for biomedical models of how the disease manifests (both in proximate and ultimate terms), and these lines of research are crucial for understanding and treating the disease.
And to your great point of how all forms of therapy seem to have roughly equivalent rates of effectiveness (all other things being equal)….. I’d say that many proponents of evolutionary psychology tend to be highly ambitious about the feasibility of science one day fully unlocking the secrets of the mind, and I’m no exception. To my mind, the finding about the equivalent efficacy of all forms of treatment (given that this efficacy is not 100%) just shows that nobody has gotten it right yet; nobody quite understands what’s going on up there as well as they think they do. Which is where, in my opinion, evolutionary approaches come in…if I didn’t feel evolution was the best way to understand mental illness (and the mind as a whole), I’d be advocating Creationist Psychology!
Dan, your use of multiple terms cracks me up! But I have to wonder – as you’ve nicely outlined the history of applying evolution to mental disorder here – if it is preferable to create a unified field, or whether you think an individual approach will always be needed? Given that some of the psychopathologies in question are so rare (thinking schizophrenia at ~1%), and admitting that there is sound research presenting that individual differences CAN remain and be selected for in a population, I still have to wonder if psychopathologies might just be idiosyncratic enough to necessitate different approaches for different practitioners/clients. As an outsider, there even seems to be great variability in non-evolutionary clinical approaches employed today (CBT, psychoanalysis, talking methods, etc.) And each seems to have about the same rate of effectiveness. Do you predict the same variety in evolutionary approaches to clinical psychology?