Tribe by Sebastian Junger and the Strange Diseases of Progress

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The subject of unsolved mysteries is one of those topics which can be reliably counted on to spark people’s interest, making it ideal for clickbait lists, questionable cable programs, and, in our own case, blog introductions. Though the unsolved mystery I want to start with does not involve pyramids, or Atlantis, or the identity of Jack the Ripper, you’re probably not even aware that it is a mystery. But not only is it one of the most profound mysteries of our age, but unlike the pyramids, Atlantis, and Jack the Ripper this mystery has serious implications for the future of society.

I first encountered this mystery when I read a review of Empire of the Summer Moon. The review was written by Scott Alexander of Slate Star Codex (though it appeared in his previous blog.) The review mentions a curious fact:

All of the white people who joined Indian tribes loved it and refused to go back to white civilization. All the Indians who joined white civilization hated it and did everything they could to go back to their previous tribal lives.

This is the mystery. If modern society is so awesome why did it hold no appeal for the American Indians? At the time, I just filed this fact in the bin, unsure at the moment of what to do about it. Then, a couple of months ago I read the book Tribe, by Sebastian Junger. And he also mentioned this same mystery. Of course Alexander and Junger are not the first people to notice this, and both of them end up quoting from Benjamin Franklin who witnessed this phenomenon first hand:

When an Indian Child has been brought up among us, taught our language, and habituated to our Customs, yet if he goes to see his relations and makes one Indian Ramble with them, there is no perswading him ever to return. But when white persons of either sex have been taken prisoner young by the Indians, and lived a while with them, tho' ransomed by their Friends, and treated with all imaginable tenderness to prevail with them to stay among the English, yet in a Short time they become disgusted with our manner of life, and the care and pains that are necessary to support it, and take the first good Opportunity of escaping again into the Woods, from whence there is no reclaiming them.

Junger also quotes from a french émigré named Hector de Crèvecoeur who was writing in 1782:

Thousands of Europeans are Indians, and we have no examples of even one of those Aborigines having from choice become European.

What made the American Indian tribes so appealing to the Europeans, and made the Europeans so unappealing to the Indians? And does this imbalance hold any lessons for us today? Junger’s book tries to answer that question, and it ends up being one of the few books where I wish it had been longer, but what he did write about was so great that I immediately knew it deserved a post.

Before I get into the book, however, I want create a framework for things first. I don’t think I’m being too controversial when I say that the vast majority of people feel like 2017 is a lot better than 1917 or 1817 and it’s certainly a lot better than 1017. I would probably count myself among those people. But how do we know that the past was worse? And what standard are we using to decide that it was worse? We can use things like deaths, or disease, or caloric intake, or maybe percentage of people in slavery to estimate what things were like, but when it really comes down to it we don’t know. Especially as we begin to consider more subtle topics like life satisfaction or the ideal way to build a community.

As an example of what I mean, let’s go back to a book I frequently reference, Better Angels of Our Nature, by Steven Pinker. One of the big themes of the book is that deaths from warfare have declined dramatically over the last few centuries. And that consequently the world is a better place. In support of this Pinker provides lots of graphs, one of which looks at various archaeological digs, and extrapolates the percentage of violent deaths in different eras. If you look at this graph you’ll see that by far the highest percentage of violent deaths was found at an archeological dig in South Dakota dating to the 1300s. This event has come to be known as the Crow Creek Massacre. And it might be an outlier, but even if it is, everyone pretty much agrees, Pinker especially, that American Indians experienced violent death at easily 10 times the rate  present in any modern society. But yet these are the same American Indians Benjamin Franklin and Crèvecoeur were talking about, whose society was so attractive that no one ever voluntarily left it. If violent death is a one to one proxy for unhappiness then this would have never been the case. We all assume that a lower chance of death leads to greater happiness, and yet this is evidence that that’s not the case. That we might not understand the past as well as we thought.

If American Indians provided the only example of this counterintuitive result, it would still be a mystery, and it would still be interesting, but I wouldn’t be writing about it. But as Junger shows in his book, this is not the only example of things being the opposite of what we might expect. And consequently the topic deserves a closer look because something similar is happening even today.

For a look at more recent examples of this Junger turns to his experiences during the Siege of Sarajevo in the early 90’s. As you can surely imagine the conditions were terrible. Junger described it thusly:

Over the course of the three-year siege almost 70,000 people were killed or wounded by Serb forces shooting into the city--roughly 20 percent of the population. The United Nations estimated that half of the children in the city had seen someone killed in front of them.

Violence on that scale is scarcely imaginable for most people in a developed country. And the natural assumption is that all of the people who lived through the siege must have been scarred for life, particularly the children, and yet when Junger returned there 20 years later he found that people missed the war, that “they longed for those days. More precisely they longed for who they’d been back then.”

Junger interviews one Bosnian journalist who was seventeen at the start of the siege. After being severely wounded by shrapnel, she was eventually evacuated to Italy. But she missed the wartime camaraderie so much that she went back to Sarajevo, crossing the lines to do so. Twenty years later when Junger talks to her he asks her if people had ultimately been happier during the war. Her response was, “We were the happiest, and we laughed more.”

Sarajevo is by no means the only example of this. At the beginning of World War II when the United Kingdom was preparing for inevitable aerial bombardment by Germany, or what came to be called the Blitz, the government assumed that it would cause mass hysteria among the population. But nothing of the sort happened. As Junger describes it:

On and on the horror went, people dying in their homes or neighborhoods while doing the most mundane things. Not only did these experiences fail to produce mass hysteria, they didn’t even trigger much individual psychosis. Before the war, projections for psychiatric breakdown in England ran as high as four million people [roughly 10% of the population], but as the Blitz progressed, psychiatric hospitals around the country saw admissions go down… Psychiatrists watched in puzzlement as long-standing patients saw their symptoms subside during the period of intense air raids.

That last bit is particularly interesting. It’s not just that normal people pulled together during the Blitz, but more interestingly, the number of people suffering from mental illness and the severity of those illnesses actually declined. And, lest you think this was a particularly English, stiff upper lip response, the same thing happened in Germany which suffered far worse aerial bombardment than England. The Allies expected that this massive bombing campaign would destroy German resolve, and in the end it did the opposite. Industrial production actually rose during the war, and the cities in Germany which hadn’t been bombed ended up being where morale was the lowest.

But of course, as I said in the beginning this sort of thing is the opposite of what we’re lead to expect. We expect war to be psychologically damaging in a way that nothing else is. This expectation certainly didn’t start with Vietnam, but it was arguably popularized by it. Everyone has seen movies depicting Vietnam vets as broken individuals, who were never quite the same after their experiences, and this trend has continued through to the present wars. But how do we reconcile this idea with the stories and examples I’ve already related?

You might not think that it needs to be squared, that everything I’ve said thus far can be dismissed as anecdotal evidence, but this is an issue that has been studied and the results are unequivocal: Large scale disasters improve mental health. The only question is why. For Junger the answer that it re-establishes the tribal societies of the past. This is the link between Sarajevo and the American Indian, between the English and the Germans, and this is where the title of the book comes from. But unlike Junger I’d like to focus more on the disease than on the cure.

If psychological damage due to war and disaster is part of the disease, then the most common symptom of that disease is PTSD, or Posttraumatic Stress Disorder.  And indeed the rates of PTSD among returning veterans has reached an historic high, and yet, combat deaths are as low as they’ve ever been. Junger compares the various wars:

This is not a new phenomenon: decade after decade and war after war, American combat deaths have generally dropped while disability claims have risen. Most disability claims are for medical issues and should decline with casualty rates and combat intensity, but they don’t. They are in an almost inverse relationship with one another. Soldiers in Vietnam suffered one-quarter the mortality rate of troops in World War II, for example, but filed for both physical and psychological disability compensation at a rate that was 50 percent higher… Today’s vets claim three times the number of disabilities that Vietnam vets did, despite...a casualty rate that, thank God is roughly one-third what it was in Vietnam.

If you parse this out, Vietnam vets had a disability per casualty rate that was six times higher than World War II vets and current vets have a disability per casualty rate 54 times as high as the World War II vets! You may or may not have noticed that I engaged in a subtle flip. We were talking about how warfare improves mental health and suddenly we’re talking about how modern wars appear to do the opposite. But of course these two things are just opposite sides of the same coin. All of things we talked about leading up to this involved intense bonding experiences, which affected an entire community all at once. Creating what one of the people who’s studied this issue called a “community of sufferers”. With that in mind the difference between World War II and Vietnam and the current wars in the Middle East and Afghanistan becomes obvious. At each step war become less of a community effort and more something that some people do in a far away place that has nothing to do with the rest of us.

In fact people who do more fighting end up with fewer psychological issues. As illustrated by the following statistics:

• During the Yom Kippur War Israeli rear-base troops had psychological breakdowns at three times the rate of the frontline troops.
• 80 percent of the psychiatric casualties in the US Army’s VII Corps came from support units which were never under fire.
• During World War II, American airborne units, which saw the most intense fighting had some of the lowest psychiatric casualty rates.
• Returning to the Yom Kippur War, Israeli commanders suffered four times the mortality rate but had only one-fifth the rate of psychological breakdown.

It appears that the more modern and safe the war experience is, the more likely someone is to develop some form of disability. As the final example, Junger reports that, roughly half of Iraq and Afghanistan veterans have applied for permanent PTSD disability, but only 10 percent experienced any actual combat. Obviously one possibility for explaining this is that people may be imagining, exaggerating or even faking their symptoms. Junger mentions that possibility, of course, but even after accounting for that the increases in psychological disability remain. Additionally there is another statistic which is also going up and is unlikely to be faked, and that’s veteran suicides.

If PTSD is the most common symptom of the disease then the worst symptom is suicide, and here again the situation is counterintuitive. Of course, as I mentioned in a previous post much of what we know about suicide runs contrary to expectations regardless of whether it’s the suicides of veterans or the suicides of teens. Though this observation does nothing to make it less tragic.

Suicide is another area where the comparison between modern society and tribal societies is illuminating. Among the American Indians depression based suicide was essentially unknown. And when the Piraha, a tribe that lives deep in the Amazon, were told about suicide they laughed because the idea was so hard to comprehend. Sometimes I don’t think we’re any closer than the Piraha to comprehending suicide, but despite that, no one is laughing.

When examining veteran suicides we see the same things that we saw with PTSD. Specifically that there is no relationship between suicide and combat. Veterans who were never under fire are just as likely to commit suicide as veterans who were under fire, and in fact among recent veterans, “deployment to Iraq or Afghanistan actually lowers the risk of suicide.” As I said at the start this is one of the great unsolved mysteries.

Having spent most of our time looking at the disease through the lens of war and the military it’s time to ask if it’s present in society at large. And the answer to that would have to be yes. In fact the evidence is all around us. If suicide and depression are its symptoms then there is no shortage of examples.

The question we then have to ask is whether these symptoms are getting worse or better, and this is where we come back to one of the subjects I started with. The idea that we can’t, or in any case don’t, know what the past was like. This is particularly true when it comes to a condition like PTSD, which wasn’t even added to the psychological lexicon until 1980 (though there were precursors as early as 1952). Thus, we don’t know if Roman centurions had PTSD, we don’t know if survivors of the Black Death, or of the Lisbon Earthquake had PTSD. And when it comes down to it, we don’t even know much about PTSD outside of richer countries. But as I pointed out what we do know seems to indicate that it might in fact be a modern phenomenon

If Junger is right and the disease stems from not having to struggle, and feeling isolated, then it makes sense that lots of people should be grappling with this disease, since the modern world abounds in both those qualities, in fact you would expect it to be getting worse. But is there any evidence for that?

You may have recently heard that there has been a big increase in deaths among the white working class. This was first pointed out by Nobel Prize winner Angus Deaton and his wife Anne Case when they published a paper showing that while every other group was experiencing a decrease in mortality, for white working class individuals the death rate was going up. It’s unclear why it took so long to notice this, but now that it’s been pointed out the trend is an obvious one and it meshes very well into the opiate epidemic which I wrote about previously. As more information has come out about the nature of these deaths and as the phenomenon get’s more attention it’s acquired a label: Deaths of Despair.

I’m going to go a little bit out on a limb here, and engage in some speculation, as well, by declaring that rising levels of PTSD and deaths of despair are just the tip of the iceberg. That we have a real and growing problem and that progress is making it worse. Most people are going to find that hard to believe, and it’s easy to talk about the benefits of progress and modernity if you’re not one of those that progress has left behind. And to be clear its beneficiaries get to do most of the talking, while it’s victims have been largely silent. Thus you end up in a situation where when the half of the country that hasn’t gotten quite as good deal elects someone which, at one point, was declared to have a better chance of playing in the NBA Finals than winning the presidency, it’s doubly shocking. First, that it happened at all, and second that no one saw it coming. But that’s the part of the iceberg that’s under water. We may notice the deaths (eventually) but they sit on top of a huge number of people who are experiencing all of the things that Junger was talking about: They don’t have anything left to struggle for, and they certainly don’t have a community to struggle with.

The drug overdoses, the alcoholism and the suicides all sit on top of a large group of people suffering from the disease, whose symptoms are largely invisible. These sufferers include males who don’t have a single close friend or spouse to say nothing of a community. It includes the millions of people who’ve given up looking for work. It includes some of the 1 in 3 millennials who live at home with their parents, 25% of whom are not working or going to school. And it probably includes the people who have decided that it’s easier to sit at home and play video games all day.

Normally it’s easy to dismiss stuff like this by saying that things are getting better, the world is getting richer, technology is getting cooler, everything is getting easier. But those arguments don’t work in this case, because all of those things are very probably making the situation worse. And if they are making it worse how much worse is it going to get?

Our world is full of assumptions. We assume that eliminating struggle is a worthwhile goal. We assume that an eventual life of leisure is what everyone needs. We assume the past was worse than the present. We assume we know what we’re doing. And we assume that peace is always good and war is always bad. And when we make an assumption with disastrous consequences, we correct it, but what about when we make assumptions that have subtle negative consequences, creating diseases of society that only turn up years or decades later?  If this is what’s happening, will we be wise enough to examine all of these assumptions and admit that maybe we’re wrong?

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