Genes, Memes, Culture, and Mental Illness

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1 Genes, Memes, Culture, and Mental Illness

3 Hoyle Leigh Genes, Memes, Culture, and Mental Illness Toward an Integrative Model 123

4 Hoyle Leigh University of California San Francisco California USA ISBN e-isbn DOI / Springer New York Dordrecht Heidelberg London Library of Congress Control Number: Hoyle Leigh, 2010 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 For Vinnie, My Partner in this Epigenetic Journey Of Genes, Memes, Culture, and much more...

7 Preface How do genes interact with the environment? How does the environment actually enter the body to affect the genes? When we perceive the environment, bits of information are encoded within the brain as memory, which consists of a series of neural connections, a brain code (see Chapter 9). When perception occurs, the new sensory input interacts with existing memory and creates new memory. Primitive memory formed by trial and error died with the organism. With the evolution of complex brains, however, memory in the form of brain codes acquired the ability to skip from one brain to another, first by imitation as a shortcut to trial and error, and later, with language, as knowledge and information. When memory achieved portability, it became memes, bits of replicating information (see Chapters 8 and 9). Memes, like genes, undergo Darwinian evolution in a complex relationship with genes. In our time, it is the gene meme environment interaction that is fundamental in understanding mental health and illness. This book integrates the concepts of genes and memes in understanding mental illness as a final common pathway brain dysfunction. The brain dysfunction is manifested by the symptoms and signs of mental illness that are determined by both genes and memes. In Part I. What is Mental Illness? An Epigenetic Model, we consider the current model of mental illness based on gene environment interaction and stress. The concept of epigenesis how genes are switched on or off by the environment is discussed. I introduce the concept of memes as perception and memory, neural entities introduced from the environment and interacting with genes and existing memes, and build a case for gene meme environment interaction model of mental illness. In Part II. Evolution and Mental Health: Genes, Memes, Culture, and the Individual, we discuss and integrate the basic concepts of genetics, evolution, and memes and how learning led to the emergence of memes. We then examine how memes are actually stored in the brain, and how they evolve within the brain as well as outside the brain as elements of culture. We discuss beneficial, symbiotic, and pathogenic memes and how the latter may enter the brain under the radar. I discuss mental health and mental illness in the light of gene meme environment interaction and propose that mental health is achieved when a democracy of memes representing the self (selfplexes) is achieved in the brain. vii

8 viii Preface In Part III. Principles of Diagnosis and Treatment of Mental Illness, I propose a new psychiatric diagnostic scheme based on gene meme interaction, epigenesis, and the concept of final common pathway brain dysfunction with replication of pathologic memes. I propose that the diagnostic scheme should be multiaxial, and that Axis I should be for phenomenological, neurophysiomemetic diagnosis based on a continuum of brain function while Axis II should be for genetic and neuroscience diagnosis. I then discuss existing and to-be-developed techniques for making a memetic diagnosis. I propose that effective treatment for mental illness should be geared toward both genes and memes, and discuss memetic therapeutic approaches. Memetic therapy may be broad-spectrum or specific. I discuss existing psychotherapies from a memetic perspective as well as the need for novel memeoriented therapies. Virtual reality therapy utilizing avatars (virtual image of oneself with desirable attributes) is a promising novel technique. Prevention is of utmost importance as vulnerable individuals could be identified in early childhood and immunization against toxic memes may prevent an epigenetic cascade toward mental illness. Education plays a crucial role in strengthening the meme-filtering, meme-sorting, and other meme-processing skills. In Part IV. Specific Psychiatric Syndromes, I discuss specific proposed Axis I (neurophysiomemetic) psychiatric syndromes under the categories of (1) attentioncognition spectrum syndromes (delirium, dementia, attention deficit and impulse control syndromes, obsessions, compulsions), (2) anxiety-mood spectrum syndromes (anxiety, panic, phobias, acute stress disorder (ASD), PTSD, borderline, mania, dependent traits and personality, avoidant traits and personality, depressionneurotic and major depressive syndrome, adjustment disorders), (3) reality perception spectrum syndromes (imagination, dissociation, conversion, somatoform, misattribution somatization, psychosis), (4) pleasure spectrum syndromes (substance use/abuse, addictions to substances, beliefs, fanaticism), (5) primary memetic syndromes (eating disorders, factitious disorders, malingering, meme-directed destructive behaviors). We focus on the memetic diagnosis, gene meme interaction in development, and genetic memetic treatment for each category. In the last chapter, Future Challenges, I briefly discuss the testable hypotheses derivable from our model of gene meme environment interaction, and the need to develop new techniques in memetic diagnosis and treatment as well as their ethical considerations. The seemingly perennial dichotomy of mind and body becomes irrelevant with the concept of memes there is no single mind but a sea of memes in the brain. What is perceived as my mind at a particular time is but a large wave crashing on the shore of my consciousness. This work is intended to integrate the seemingly disparate languages and methods of biological and social sciences around the indivisible organism, the patient. It is intended to stimulate thinking and hopefully innovations among psychiatrists, physicians of other specialties, health-care professionals, psychologists, sociologists, anthropologists, and others who are interested in human behavior and emotions.

9 Preface ix I am grateful to my colleagues and students who have stimulated my thinking through discussions and arguments. I thank Janice Stern of Springer for her support and help in all phases of this work, and Vinnie for putting up with my late and early hours of writing and exchanging genes, memes, culture, and much more. Fresno and San Francisco, CA October, 2009 Hoyle Leigh, MD

11 Contents Part I What Is Mental Illness? An Epigenetic Model 1 Genes and Mental Illness The Evolution of the Concept of Mental Illness Gene-Environment Interaction and Brain Morphology and Function Gene Environment Interaction: Serotonin Transporter GeneasanExemplar Emerging Model of Mental Illness: Gene Meme Interaction 7 References How Does Stress Work? The Role of Memes in Epigenesis Stress,Aging,andDisease Stress,Memes,andtheBrain Role of Stress and Nurturing in Development: Epigenesis Environment Changes Epigenome Memes and Epigenesis Stress Awakens Dormant Memes Resulting in Mental Illness. 21 References Culture and Mental Illness CultureandPresentingSymptoms Culture-Specific Psychiatric Syndromes EnculturationandMemes MemesforBeingIll References Genetic Memetic Model of Mental Illness Migration and Natural Disasters as Illustrations Migration NaturalDisasters References xi

12 xii Contents Part II Evolution and Mental Health: Genes, Memes, Culture, and the Individual 5 What Do We Inherit from Our Parents and Ancestors? LikeParent,LikeChild HowDoesCultureAffectBehavior? Memes and Cultural Change Memeplexes References Genes Human Genes Mendelian Genetics Genes and Mutation Sex-Linked Genes Polygenic Inheritance How Do Genes Work? References Evolution In the Beginning In a Changing, Hostile World TheSelfishGene Wonderful Random Errors Wonderful Invention of Sex DarwinandNaturalSelection SomaticEvolution UniversalDarwinism References Learning, Imitation, and Memes EvolutionofComplexOrganisms TrialandError LearnorPerish Imitation, Shortcut to Learning CoevolutionoftheBrainandMemes EmpathyandMirrorNeuronSystem Meme Generation and Meme Infection WhatIsaMeme? References Storage and Evolution of Memes in the Brain StorageofMemesasMemory ImplicitMemory ExplicitMemory Learned Fear LearningSafety

13 Contents xiii WorkingMemory EvolutionofMemesintheBrainandtheBrainCode References External Storage of Memes: Culture, Media, Cyberspace NicheCulture HowMemesJumpBrains CommunicationandMemes Memes as a Paradigm Shift in Evolution andextraterrestrialdiffusionofmemes Cyberspace and Extracerebral Memes ImplicationofLiberationofMemesfromBrains References Culture and the Individual Culture as Memetic Niches Individual Brain in a Petri Dish of Culture Memes, Culture, and Anthropology Dominant and Nondominant Memes in Cultures, Zeitgeist,DeviousMemes PathologicMemes Memes That Inhibit or Attenuate the Brain s Executive (Ego) Function: Tradition and Prejudice Memes That Are Devious, Entering Under False Pretenses, Then Causing Disease or Destruction Memes that Replicate Virulently, Often Bypassing the Executive Function Memes that Are Virulent Because They Arouse Passion, Bypassing Executive Function Memes that Cause an Indolent Infection, to Become Virulent Later Protective Memes and the Placebo Effect How Memes Come in Under the Radar SpreadofMemes Internal Processing of Memes and Consciousness: ThinkingasMemeManipulation FreeWill The Unconscious, Collective Unconscious, Freudian Unconscious Selfplex and the Shadow: We Are All Multiple Personalities Transcendence The Individual as a Pawn in the War of Memes References

14 xiv Contents 12 What Is Mental Health? Normality and Health Gene MemeInteractionandMentalHealth Neurobiology of Pleasure, Punishment, and Inhibition MentalHealth:ADemocracyofMemes References What Is Mental Illness? Unhappiness MemesandMentalIllness CultureandMentalIllness Mental Illness and Psychiatric Syndromes References Part III Principles of Diagnosis and Treatment of Mental Illness 14 Psychiatric Diagnosis: Toward a Memetic Epigenetic Multiaxial Model Psychiatric Diagnosis and Problems with DSM What Is Diagnosis? Psychiatric Diagnosis: Dysregulation and Final Common Pathway Syndromes, Resurrection of Neurosis Proposal for a New DSM Scheme Axis I: Memetic/Phenomenological (Neurophysiomemetic) Diagnosis: Psychiatric Syndromes, Symptoms, and Traits, Based on Deviations of Normal Brain Function Axis II: Geno-Neuroscience Diagnosis: Genes (Including Family History of Psychiatric Illness), Brain Morphology, Biochemistry and Pathology, Functional Changes and Conditions Potentially Influencing Axis I AxisIII:MedicalDiseasesandConditions Axis IV: Stresses: Childhood, Recent, and Current Axis V: Psychosocial Assets and Recent/Current Functioning Axis VI: Biopsychosocial and Epigenetic Formulation AnIllustrativeCase References Memetic Diagnosis, Memetic Assessment and Biopsychosocial Epigenetic Formulation Memetic Diagnosis MemeticAssessment

15 Contents xv 15.3 ConsciousMemes Unconscious Memes Priming Factors and Role Models The Need for New Memetic Diagnostic Tools References Principles of Memetic Therapy Blocking the Entrance and Induction of Pathogenic Memes TreatingMemesintheBrain Identifying Pathogenic Memes and Memeplex Components IdentifyingCapsulesandVehicles NeutralizingCapsulesandVehicles Deconstructing and Suppressing Memes AugmentingProtectiveMemes Conventional Meme Directed Therapies NeedforNovelTherapies References Broad-Spectrum Memetic Therapies What is Broad-Spectrum Meme-Oriented Therapy? Sleep, Sedation, and Electroconvulsive Therapy RelaxationandMeditation Hypnosis Music and Dance Therapy MassageTherapy Exercise Bibliotherapy References Specific Memetic Therapies Psychotherapies as Memetic Therapies Behavior Therapy, Dialectical Behavior Therapy (DBT), Cognitive Behavioral Therapy (CBT), Rational Emotive Behavioral Therapy (REBT), Interpersonal Therapy (IPT) Psychodynamic Psychotherapy Toward a United, Integrated Memetic Concept of Psychotherapy Need for New Meme-Literate Psychotherapies References Genetic Memetic Prevention Epigenesis in Prevention Early Diagnosis and Treatment of Vulnerable Children Early Protection from Pathogenic Memes Vaccination

16 xvi Contents 19.5 Education Gene Meme Cooperation vs. Gene Meme Conflict: Mind and Body References Part IV Specific Psychiatric Syndromes 20 Overview of Specific Syndromes Introduction Gene Meme Symbiosis and Mental Illness Toward a Dimensional Approach in Identifying andtreatingmentalillness Attention-Cognition Spectrum Syndromes: Delirium, Dementia, Impulse Control Syndromes, ADHD, Antisocial Personality, Obsessive-Compulsive Personality Traits, Obsessive-Compulsive Syndrome Gene Meme Interaction, Evolutionary Adaptation, and Syndromes Global Dysregulation of Meme Processing: DeliriumandDementia Dysregulation of Infrastructure for Meme Processing: Attention-Deficit Disorder (ADHD), Impulse and Aggression Dyscontrol, Antisocial Personality Dysregulation of Meme-Processing Loop: Preoccupations, Obsessions, Compulsions Treatment References Anxiety-Mood Spectrum Syndromes: Anxiety, Panic, Phobias, ASD, PTSD, Borderline Syndrome, Dependent and Avoidant Personalities, Social Phobia, Bipolarity and Mania, Depression Neurotic and Syndromic, Adjustment Disorders Gene Meme Interaction, Evolutionary Adaptation, and Syndromes Anxiety Panic Syndrome and Agoraphobia Specific Phobias Acute Stress and Posttraumatic Stress Syndromes Borderline Syndrome and Traits Dependent Personality Traits and Syndrome Avoidant Personality Traits and Syndrome, Social Phobia

17 Contents xvii BipolarityandMania Depression Neurotic and Major Depressive Syndrome AdjustmentDisorders Treatment Prevention Mild Symptoms (Problems of Living andadjustmentreactions) Neurosis Major Syndromes References Reality Perception Spectrum Syndromes (Imagination, Dissociation, Conversion, Somatoform, Misattribution Somatization, Psychosis) Gene Meme Interaction and Evolutionary Adaptation ImaginationandDreaming Dissociation Dissociative Identity Disorder (DID, Multiple Personality) Misattribution Syndromes: Conversion, Somatization, Hypochondriasis, Chronic Pain(SomatoformDisorders) Psychosis Schizophrenia Treatment Mild Dissociative Symptoms, Dissociation in Borderline Syndrome, PTSD Dissociative Identity Disorder (DID, Multiple Personality Syndrome) Misattribution Syndromes: Conversion, Somatization, Hypochondriasis, Chronic Pain,Fibromyalgia,etc Psychosis and Schizophrenia References Pleasure Spectrum Syndromes (Substance Use/Abuse, Addictions to Substances and Beliefs, Fanaticism) Gene Meme Interaction, Evolutionary Adaptation, and Syndromes Substance Use/Abuse Addictions to Substances and Beliefs, Fanaticism Treatment References

18 xviii Contents 25 Primary Memetic Syndromes: Eating Disorders, Factitious Disorders, Malingering, Meme-Directed Destructive Behaviors Gene Meme Interaction, Evolutionary Adaptation, and Syndromes EatingDisorders Destructive Meme Infections and Epidemics: Mass Hysteria, Factitious Illness, Suicide, SuicideBombing,Aggression Irrational Beliefs and Delusions Treatment References Challenges for the Future Genes and Memes How to Achieve a Peaceful Coexistence Need for New Diagnostic and Therapeutic Approaches andtools Testable Hypotheses of Gene Meme Environment Interaction Memes, Social Sciences, and Neuroscience EthicalConsiderations Post-humanEvolutionofMemes Index

Contents Part I What Is Mental Illness? An Epigenetic Model Genes and Mental Illness How Does Stress Work? The Role of Memes in Epigenesis

Contents Part I What Is Mental Illness? An Epigenetic Model 1 Genes and Mental Illness... 3 1.1 The Evolution of the Concept of Mental Illness... 3 1.2 Gene-Environment Interaction and Brain Morphology