Elsevier

Clinical Psychology Review

Review

Why we heal: The evolution of psychological healing and implications for global mental health

Under a Creative Commons license

Open access

Highlights

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Understanding biocultural evolution of psychosocial healing helps improve current practice.

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Psychological healing is a component of cooperative processes related to evolutionary fitness.

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Social rupture and social repair are features of cooperative social species including humans.

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Healing comprises empathy, mirroring, emotional contagion, self-regulation, and mentalizing.

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Healing among humans involves symbolic processes requiring shared meanings of symbols.

Abstract

Why do humans heal one another? Evolutionary psychology has advanced our understanding of why humans suffer psychological distress and mental illness. However, to date, the evolutionary origins of what drives humans to alleviate the suffering of others has received limited attention. Therefore, we draw upon evolutionary theory to assess why humans psychologically support one another, focusing on the interpersonal regulation of emotions that shapes how humans heal and console one another when in psychosocial distress. To understand why we engage in psychological healing, we review the evolution of cooperation among social species and the roles of emotional contagion, empathy, and self-regulation. We discuss key aspects of human biocultural evolution that have contributed to healing behaviors: symbolic logic including language, complex social networks, and the long period of childhood that necessitates identifying and responding to others in distress. However, both biological and cultural evolution also have led to social context when empathy and consoling are impeded. Ultimately, by understanding the evolutionary processes shaping why humans psychologically do or do not heal one another, we can improve our current approaches in global mental health and uncover new opportunities to improve the treatment of mental illness across cultures and context around the world.

Keywords

Evolution

Mental health

Medical anthropology

Psychotherapy

Placebo effect

Traditional medicine

Cited by (0)

Brandon A. Kohrt, MD, PhD, holds the Charles and Sonia Akman Professorship in Global Psychiatry at George Washington University, where he is Associate Professor of Psychiatry and Behavioral Sciences, Global Health, and Anthropology, and Director of the Division of Global Mental Health. Dr. Kohrt has worked with children and families affected by war and political violence, disasters, and other forms of adversity around the world. Dr. Kohrt's work also addresses reducing stigma in healthcare settings to improve the quality of mental health services. He co-edited the book, Global Mental Health: Anthropological Perspectives.

Katherine Ottman, MSc, is a Research Associate at the George Washington University Global Mental Health Equity Lab, where she is currently involved in the Identification of Depression in Early Adolescence (IDEA) project and UNICEF Measuring Mental Health of Adolescents at the Population level (MMAP) program and qualitative components of several other projects involving depression in adolescents. She holds a B.A. in Anthropology from the College of William and Mary and an MSc in Public Health from the London School of Hygiene and Tropical Medicine, where she completed her dissertation on the implementation processes of mental and psychosocial health interventions in conflict-affected populations.

Catherine Panter-Brick, PhD, is the Bruce A. and Davi-Ellen Chabner Professor of Anthropology, Health, and Global Affairs at Yale University.  She is an expert on risk and resilience, having spent three decades working with people affected by war, poverty, and marginalization.  A medical anthropologist, she was trained in both human biology and the social sciences. She has extensive experience leading mixed-methods research, having directed over forty interdisciplinary projects in Afghanistan, Ethiopia, the Gambia, Jordan, Mexico, Nepal, Niger, Pakistan, Saudi Arabia, Tanzania, the UK and the USA.  For her work in humanitarian areas, she received the Lucy Mair Medal, awarded by the Royal Anthropology Institute to honor excellence in the application of anthropology to the active recognition of human dignity.  At Yale University, she directs the Global Health Studies Multidisciplinary Academic Program, the Program on Conflict, Resilience, and Health and the Program on Stress and Family Resilience, and leads research initiatives to develop effective partnerships between scholars, practitioners, and policymakers.

Melvin Konner, MD, PhD, is the Samuel Candler Dobbs Professor of Anthropology at Emory University. He co-founded the Anthropology & Human Biology major and has been a core member of the Neuroscience and Behavioral Biology faculty since that program was founded. He is also affiliated with the Tam Institute of Jewish Studies. Long committed to fostering the public understanding of anthropology and evolution, he has written for The New York Times, The Wall Street Journal, The New York Review of Books, Newsweek, Salon.com, and many other publications both academic and general. He has testified twice at U.S. Senate hearings related to health care. Konner is a Fellow of the American Association for the Advancement of Science and was elected to the American Academy of Arts and Sciences in 2016. He was a trustee of the Russell Sage Foundation (2000-2010) and received the John McGovern Award in Medical Humanities from the Yale School of Medicine. He has written numerous books including Believers: Faith in Human Nature (2019), Women After All: Sex, Evolution, and the End of Male Supremacy (2015), and Evolution of Childhood: Relationships, Emotion, Mind (2010).

Vikram Patel is The Pershing Square Professor of Global Health and Wellcome Trust Principal Research Fellow at the Harvard Medical School. He co-leads the [email protected] initiative. His work has focused on the burden of mental health problems, their association with social disadvantage, and the use of community resources for their prevention and treatment. He is a co-founder of the Movement for Global Mental Health, the Centre for Global Mental Health (at the London School of Hygiene & Tropical Medicine), the Mental Health Innovations Network, and Sangath, an Indian NGO which won the WHO Public Health Champion of India prize. He is a Fellow of the UK's Academy of Medical Sciences and has served on the Committee which drafted India's first National Mental Health Policy and the WHO High Level Independent Commission for NCDs. He has been awarded the Chalmers Medal, the Sarnat Prize, the Pardes Humanitarian Prize, an Honorary OBE and the John Dirk Canada Gairdner Award in Global Health. He was listed in TIME Magazine's 100 most influential persons of the year in 2015.

© 2020 The Authors. Published by Elsevier Ltd.