The Evolved Self-Management System

Nicholas Humphrey in Edge:

I was asked to write an essay recently for “Current Biology” on the evolution of human health. It's not really my subject, I should say, but it certainly got me thinking. One of the more provocative thoughts I had is about the role of medicine. If human health has changed for the better in the late stages of evolution, this has surely had a lot to do with the possibility of consulting doctors, and the use of drugs. But the surprising thing is that, until less than 100 years ago, there was hardly anything a doctor could do that would be effective in any physiological medicinal way—and still the doctor's ministrations often “worked”. That's to say, under the influence of what we would today call placebo medicine people came to feel less pain, to experience less fever, their inflammations receded, and so on.

Now, when people are cured by placebo medicine, they are in reality curing themselves. But why should this have become an available option late in human evolution, when it wasn't in the past.

I realized it must be the result of a trick that has been played by human culture. The trick isto persuade sick people that they have a “license” to get better, because they'rein the hands of supposed specialists who know what's best for them and can offer practical help and reinforcements. And the reason this works is that it reassures people—subconsciously —that the costs of self-cure will be affordable and that it's safe to let down their guard. So health has improved because of a cultural subterfuge. It's been a pretty remarkable development.

I'm now thinking about a larger issue still. If placebo medicine can induce people to release hidden healing resources, are there other ways in which the cultural environment can “give permission” to people to come out of their shells and to do things they wouldn't have done in the past? Can cultural signals encourage people to reveal sides of their personality or faculties that they wouldn't have dared to reveal in the past? Or for that matter can culture block them? There's good reason to think this is in fact our history.

More here.