[0:04]So you're a scientist and somewhere along the way hammered into your head is the inevitable nature versus nurture, and that's at least up there with Coke versus Pepsi or Greeks versus Trojans. So nature versus nurture this by now utterly oversimplifying view of where influences are, influences on how a cell deals with an energy crisis up to what makes us who we are in the most individualistic levels of personality. And what you've got is this complete false dichotomy built around nature as deterministic at the very bottom of all the causality of life, DNA and the code of codes and the Holy Grail. And everything is driven by it and at the other end a much more social science perspective, which is we are social organisms and biology is for slime molds. Humans are free of biology and obviously both views are nonsense. What you see instead is it is virtually impossible to understand how biology works outside the context of environment.
[1:21]One of the most crazy making yet widespread and potentially dangerous notions is oh that behavior is genetic. Now what does that mean? It means all sorts of subtle stuff if you sort of know modern biology, but for most people out there what it winds up meaning is ah a deterministic view of life. One rooted in biology and genetics genes equal things that can't be changed, genes equal things that are inevitable and that you might as well not waste resources trying to fix. Might as well not put societal energies into trying to improve because it's inevitable, it's unchangeable, and that is sheer nonsense.
[2:14]It is widely thought that conditions like ADHD are genetically programmed, conditions like schizophrenia are genetically programmed. The truth is the opposite. Nothing is genetically programmed. They're very rare diseases, I mean a small handful, extremely sparsely represented in the population that are truly genetically determined. Most complex conditions might have a predisposition that is a genetic component, but a predisposition is not the same as a predetermination. The whole search for the source of disease in the genome was doomed to failure before anybody even thought of it because most diseases are not genetically predetermined. Heart disease, cancer, strokes, rheumatoid conditions, autoimmune conditions in general, mental health conditions, addictions, these are none of them genetically determined. Breast cancer for example, out of 100 women with breast cancer, only seven will carry the breast cancer genes. 93 do not, and out of 100 women who do have the genes, not all of them will get cancer.
[3:30]Genes are not just things that make us behave in a particular way regardless of our environment. Genes give us different ways of responding to our environment, um and in fact it looks as if some of the early childhood influences of the kind of child rearing, uh affect gene expression, actually turning on and off different genes, um to put you on a different development developmental track, which may suit the kind of world you've got to deal with. So for example, uh a study done in Montreal with suicide victims looked at autopsies of the brains of these people. And it turned out that if a suicide victim is are usually young adults had been abused as children, the abuse actually caused a genetic change in the brain that was absent in the brains of people who had not been abused. That's an epigenetic effect, epi means on top of. So that, so that the epigenetic influence is what happens environmentally to either activate or deactivate certain genes. In New Zealand, there's a study that was done in a town called Dunedin, um in which uh a few thousand individuals were studied from birth up to their into their 20s. What they found was that they could identify a genetic mutation, an abnormal gene, which did have some relation to the predisposition to commit violence. But only if the individual had also been subjected to severe child abuse. In other words, a child with this abnormal gene would be no more likely to be violent than anybody else, and in fact they actually had a lower rate of violence than people with normal genes as long as they weren't abused as children. Great additional example of the ways in which genes are not be all and end all, fancy technique where you can take a specific gene out of a mouse, that mouse and his descendants will not have that gene, you have knocked out that gene. So there's this one gene that codes for a protein that has something to do with learning and memory, and this fabulous demonstration knockout that gene and you have a mouse that doesn't learn as well. Oh, a genetic basis for intelligence. What was much less appreciated in that landmark study that got picked up by the media left and right, is take those genetically impaired mice and raise them in a much more enriched stimulating environment than your normal mice in a lab cage and they completely overcame that deficit. So when one says in the contemporary sense that oh, this behavior is genetic, to the extent that that's even a valid sort of phrase to use, what you're saying is there is a genetic contribution to how this organism responds to environment. Genes may influence the readiness with which an organism will deal with a certain environmental challenge, you know, that's not the version most people have in their minds and not to be too soapboxing, but run with the old sort of version of it's genetic and it's not that far from the history of Eugenics and things of that sort. It's a widespread misconception and it's a potentially terribly dangerous one. One reason that the sort of biological explanation for violence, uh one reason that hypothesis is potentially dangerous, it's not just misleading, it can really do harm. Is because if you believe that, you could very easily say, well, there's nothing we can do to change the predisposition people have to becoming violent. All we can do if somebody becomes violent is punish them, you know, lock them up or execute them, but we don't need to worry about changing the social environment or the social preconditions that may lead people to become violent because that's irrelevant. The genetic argument allows us the luxury of ignoring past and present historical and social factors. And in the words of a Louis Mennard, who wrote in the New Yorker, very astutely he said, it's all in the genes, an explanation for the way things are that does not threaten the way things are. Why should someone feel unhappy or engage in anti-social behavior when that person is living in the freest and most prosperous nation on Earth? It can't be the system. There must be a flaw in the wiring somewhere, which is a good way of putting it. So the genetic argument is simply a cop out, uh, which allows us to ignore the social and uh economic and political factors that in fact underly uh many uh troublesome behaviors.
[8:46]Addictions are usually uh considered to be a drug related issue, but looking at it more broadly, I define addiction as any behavior that is associated with uh craving, with temporary relief, and with long-term negative consequences along with an impairment of control over it, so that the person wishes to give her it give it up or promises to do so but can't follow through. And when you understand that, then you can say that there are many more addictions than simply those related to drugs. There's workaholism, there's addiction to shopping, to the internet, to video games. There's the addiction to power. People have power but they want more and more and more, nothing is ever enough for them. Uh acquisition, corporations that must own more and more, the addiction to oil, at least to the wealth and to the products made accessible to us by oil. Look at the negative consequences on the environment. Uh on the very we're destroying the very Earth that we inhabit for the sake of that addiction. Now these addictions are far more devastating in their social consequences than the cocaine or heroin habits of my downtown East side patients. Yet they're rewarded and considered to be respectable. The tobacco company executive that shows a higher profit will get a much bigger reward. He doesn't face any negative consequences legally or otherwise, in fact he's a respected member of the board of several other corporations. But tobacco smoke related diseases kill five and a half million people around the world every year, uh in the United States they kill 400,000 people a year. And these people are addicted to what? To profit, to such a degree are they addicted that they're actually in denial about the impact of their uh activities, which is typical for addicts, is denial. And that's a respectable one, it's respectable to be addicted to profit no matter what the cost. So what is acceptable and what is respectable is a highly arbitrary phenomenon in our society. And it seems like the greater the harm, the more respectable the addiction.
[10:59]There's a general myth that drugs in themselves are addictive. In fact the war on drugs is predicated on the idea that if you interdict the sources of drugs, you can deal with addiction that way. Now, uh, if we understand addiction in a broader sense, we see that nothing in itself is addictive. No substance, no drug is is by itself addictive and no behavior is by itself addictive. Many people can go shopping without becoming shopaholics. Not everybody becomes a food addict. Not everyone who drinks a glass of wine becomes an alcoholic. So the real issue is what makes people susceptible because it's the combination of a susceptible individual and the potentially addictive substance or behavior that actually then makes for the for full flowering of addiction. In short, it's not the drug that's addictive, it's the question of the susceptibility of the individual to being addicted to a particular substance or behavior. If you wish to understand what then makes us some people susceptible, we actually have to look at their life experience. The old idea, although it's old, but it's still broadly held that addictions are due to some genetic cause is simply scientifically untenable. What the case is actually is that certain life experiences make people susceptible, life experiences that not only shape the person's uh personality and and psychological needs, but also their very brains in certain ways. And that process begins in Utero.
[12:34]It's been shown for example that if you stress mothers during pregnancy, their children are more likely to have traits that predispose them to addictions. And that's because development is shaped by the psychological and social environment. So the biology of human beings is very much affected by and programmed by their life experiences beginning in Utero. Environment does not begin at birth. Environment begins as soon as you have an environment as soon as you're a fetus, you are subject to whatever information is coming through mom's circulation, hormones, levels of nutrients. Great landmark example of this, something called the Dutch Hunger winter. 1944, Nazis occupying Holland, for a bunch of reasons they decide to take all the food and divert it to Germany for 3 months. Everybody there is starving, tens of thousands of people starved to death. What the Dutch Hunger winter effect is, if you were a second or third trimester fetus during the starvation, your body learned something very unique during that time. As it turns out second, third trimester, something that your body is going about trying to learn about the environment is, well, how menacing of a place is it out there, how plentiful, how how much nutrients am I getting by way of mom's circulation. Be a Dutch Hunger winter fetus, at half a century later, everything else being equal, you are more likely to have high blood pressure, obesity or metabolic syndrome.
[14:18]That is environment coming in a very unexpected place. You can stress animals in a laboratory when they're pregnant and their offspring will be more likely to use cocaine and alcohol as adults. You can stress human mothers, for example in a British study, uh women who are abused in pregnancy will have higher levels of the stress hormone cortisol in their placenta at birth and their children are more likely to have conditions that predispose them to addictions by age seven or eight. So in Utero stress already prepares the gone for all kinds of mental health issues. Israeli study done prior on children born to mothers who were who were pregnant prior to the onset of the 1967 war. Uh these women were of course very stressed and their offspring have a higher incidence of schizophrenia than the average cohort. So there's plenty of evidence now that prenatal effects have a huge impact on the developing human being.
[15:21]The point about human development and specifically human brain development is that it occurs mostly under the impact of the environment and mostly after birth. Now, if you compare us to a horse which can run on the first day of life, we see that we are very undeveloped. We can't develop, we can't muster that much neurological coordination, balance, muscle strength, visual acuity until a year and a half, two years. And that's because the brain development that in the horse happens in the safety of the womb, in a human being has to happen after birth. And that has to do with simple evolutionary logic as the head gets larger, which is what makes us into human beings, the burgeoning of the for brain is what creates the human species actually. Um at the same time we walk on two legs, so our pelvis narrows to accommodate that so now we have a narrower pelvis, a larger head, bingo, we have to be born prematurely. And that means that the brain development that in other animals occurs in Utero, in us occurs after birth. And much of that under the impact of the environment and uh the concept of neural Darwinism simply means that the circuits that get the appropriate input from the environment will develop optimally and the ones that don't will either not develop optimally or perhaps not at all. If you take a child with perfectly good eyes at birth and you put them in a dark room for five years, he'll be blind after for the rest of his life because the circuits of vision require light waves for their development. And without that, even the rudimentary circuits present and active at birth will atrophy and die and new ones will not develop.
[17:00]There's a significant way in which early experiences shape adult behavior and even and especially early experiences for which there's no recall memory. It turns out that there are two kinds of memory. There is explicit memory which is recall. This is when you can call back facts, details, episodes, circumstances, but the structure in the brain, which is called the hippocampus, which encodes recall memory, is doesn't even begin to develop fully until a year and a half and it's not fully developed until much later. Which is why hardly anybody has any recall memory prior to 18 months. But there's another kind of memory which is called implicit memory, which is in fact an emotional memory, where the emotional impact and the interpretation that the child makes of those emotional experiences is ingrained in the brain in the form of nerve circuits ready to fire without specific recall. So to give you a clear example, people who are adopted have a lifelong sense of rejection very often. They can't recall the adoption, they can't recall the separation of the birth mother, because there's nothing there to recall with, but the emotional memory of separation and rejection is deeply embedded in their brains. Hence, they're much more likely to experience a sense of rejection and a great emotional upset when they perceive themselves as being rejected than other people. That's not unique to people who are adopted, but it's particularly strong in them because of this function of implicit memory. People who are addicted, given that the according to the research literature, certainly in my experience, the hardcore addicts or a virtually will all significantly abused as children or suffered severe emotional loss, their emotional or implicit memories are those of a world that's not safe and not not helpful. Caregivers are not to be trusted and relationships that are not safe enough to open up to vulnerably. And hence their responses tend to be to keep themselves separate from really intimate relationships, uh not to trust caregivers, doctors and other people who are trying to help them and generally see the world as an unsafe place. And that's simply strictly a function of implicit memory, which sometimes has to do with incidents they don't even recall.
[19:25]Infants who are born premature are often in incubators and in various types of gadgetry and machinery for weeks and perhaps months. It's known that if these children are touched and stroked on the back for just 10 minutes a day, that promotes their brain development, so human touch is essential for development. And in fact, infants were never picked up will actually die. That how much of a fundamental need being held is to human beings. In our society, there's an unfortunate tendency to tell parents not to pick up their kids, not to hold them, not to, um, uh, pick up babies who are crying for fear of spoiling them or to to encourage them to sleep through the night. You don't pick them up, which is just the opposite of what the child needs, and these children might go back to sleep because they give up and their brain just shut down as a way of defending against the vulnerability of being abandoned really by their parents, but their implicit memories will be that of a world that doesn't give a damn.
[20:29]A lot of these uh differences uh structured very early in life. Uh in a way the, if you like, the parental experience of adversity, how tough life is or how easy it is is passed on to children whether through maternal depression or parents being bad tempered with their kids because they've had a hard day or just being too tired at the end of the day. And these have very powerful effects, uh programming children's development, which we know a lot about now. But that early sensitivity isn't just an evolutionary mistake. It exists again in many different species, even seedlings, there's an early adaptive process to the kind of environment they're growing up in. But for humans the adaptation is to the quality of social relations, and so uh early life, how nurturing or how much conflict, how much attention you get, um is a taste of the kind of world you may be growing up in. Are you growing up in a world where you have to fight for what you can get, watch your back, fend for yourself, learn not to trust others? Or are you growing up in a society where you depend on reciprocity, mutuality, cooperation, where empathy is important, where your security depends on good relations with other people? And that needs a a very different uh emotional and cognitive development and that's what the early sensitivity is about. And parenting is almost quite unconsciously a system for passing on that experience to children of the kind of world they are in. The great British child psychiatrist D.W. Winnicott said that fundamentally two things can go wrong in childhood. One is when things happen that shouldn't happen, and then things that should happen but don't. And the first category is the traumatic and abusive and abandonment experiences of my down East side patients and of many addicts. That's what shouldn't happen but did. But then there is the non-stressed, attuned, non-distracted attention of the parent that every child needs that very often children don't get. They're not abused, they're not neglected and and they're not traumatized. But what should happen, the presence of the emotionally available nurturing parent just is not available to them because of the stresses in our society and the parenting environment. And the psychologist Alan Shore calls that proximal abandonment. When the present, the parent is physically present but emotionally absent. I have spent uh oh roughly the last 40 years of my life um working with the most violent people our society produces, murderers, rapists and so on. In an attempt to understand what causes this violence. I discovered that the most violent of the criminals in our prisons had themselves been victims of a degree of child abuse that was beyond the scale of what I ever thought of applying the term child abuse to. I had no idea of the depth of the depravity with which children in our society are all too often treated. The most violent people I saw were themselves the survivors of their own attempted murder often at the hands of their parents or other people in their social environment or were the survivors of family members who had been killed, their closest family members by by other people. The Buddha argued, um, that everything depends on everything else. He says that one contains the many and the many contains the one, that you can't understand anything in isolation from its environment. The leaf contains the sun, the sky and the Earth, obviously. Uh, this has not been shown to be true of course all around and specifically when it comes to human development, the modern scientific term for it is the biopsychosocial nature of human development. Which says that the biology of human beings depends very much on their interaction with the social and psychological environment and specifically the psychiatrist and researcher Daniel Segal at University of California, Los Angeles, UCLA, has coined the phrase interpersonal neurobiology. Which means to say that the way that our nervous system functions depends very much on our personal relationships, in the first place with the parenting caregivers and in the second place with other important attachment figures in our lives and in the third place with our entire culture. So that you can't separate the neurological functioning of a human being from the environment in which he or she grew up in and continues to exist in. And uh this is true throughout the life cycle, it's particularly true when you're dependent and helpless and your brain is developing, but it's true even in adults and even at the end of life.
[29:43]In a society which is predicated on competition and uh really very often the ruthless exploitation of one human being by another, the profiteering of other people's problems and very often the creation of problems for the purpose of profiteering. The ruling ideology will very often justify that behavior by appeals to some fundamental and unalterable human nature. So the myth in our society is that people are competitive by nature and that they're individualistic and that they're selfish. The real uh reality is quite the opposite, we have certain human needs. The only way that you can talk about human nature concretely is by recognizing that there's certain human needs. We have a human need for companionship and for close contact, to be loved, to be attached to, to be accepted, to be seen, to be received for who we are. If those needs are met, we we develop into people who are compassionate and cooperative and and who have empathy for other people.
[30:54]So the opposite that we often see in our society is in fact the distortion of human nature precisely because so few people have their needs met. So yes, you can talk about a human nature, but only in the sense of basic human needs that are instinctively evoked, or I should say if certain human needs that lead to certain traits if they are met and a different set of traits if they are denied.
