It is fashionable these days to talk about moral crises that really aren’t moral crises. The level of rhetoric is at the point where disagreements can be spun as moral crises, while people are dying in the streets. The best examples I can think of are the long-standing epidemics of gun violence and racism. New examples are cropping up every day. There are current trends in violence against Asian Americans and Jews against the backdrop of long-standing trends. Discrimination and violence against black Americans is finally acknowledged as being widespread and is the basis of an activist civil movement and hopefully systematic reforms.
All of the statistics to back up my statements in the first
paragraph are easily available and I am not going to post all those references
here. Since I started writing this blog one of my concerns has been gun
violence and how to stop it given the level of interference with common sense
gun law reforms by one of the major parties and major lobbying concerns. I saw
the attempt to counter that political interference as being futile and focused
more on public health interventions and possible psychiatric intervention. The latest good review of that approach is available in a review by Knoll and Pies (3). For
many years I have advocated that homicidal ideation should be seen as a public
health intervention point and that it should be part of the strong public
health message. To this day nothing has happened. Public
health organizations do have research-based suggestions such as locking up
firearms and common-sense gun laws like banning large capacity magazines,
banning assault rifles, and universal background checks, but the general lack
of progress in that area is not reassuring. There has been some movement in
allowing more research on gun violence, an area that was previously blocked by
gun lobbyists.
What is the connection between gun violence, racism, and
violence toward our fellow Americans? I think there are all based on the same
interpersonal dynamic. That dynamic is seeing another person as being significantly
different from you, attributing negative characteristics to them, and using
both of those premises for treating them different from you up to and including
perpetrating violence toward them. In
psychiatric jargon, we use the term projection to capture this process or
in the extreme projective identification. These are not psychiatric
diagnoses, but defense mechanisms that are distributed across the population
even though they may be more likely in people with specific psychiatric
diagnoses.
In my readings over the years I have been looking for a
likely origin or at least first sign of this kind of thought pattern. In other words,
have people been thinking like this since the beginning of recorded time, or is this
a new phenomenon? In the course of that reading,
I came across a book written by the anthropologist Lawrence Keeley called War
Before Civilization. In this book, Keeley explores the idea of the noble
savage from prehistoric times. In
other words, were pre-historic people inherently peaceful as some had suggested
or were there early signs of violence and aggression. A review of the evidence
suggests that the majority of human prehistoric civilizations engaged in
frequent warfare and total warfare – in other words attacks not limited to
combatants and decimating the opposition’s infrastructure and ability to make
war. Keeley reviews the motivations and
consequences of primitive warfare in great detail including tactics (surprise
attacks, slaughter of noncombatants, and general massacres) and specific practices
like mutilating dead bodies. There is clear evidence the latter functioned in
part to dehumanize and humiliate the enemy and send a message to the survivors.
These dynamics were not limited to prehistoric man and have continued through
modern times and modern warfare.
A recent report referencing Keeley’s book appeared on Scientific
Reports (2) this week. It was a
reanalysis of a Nile Valley burial site of 61 people from about 13,400 years
ago. It is thought to be some of the earliest evidence of Homo sapiens interpersonal
violence. In that analysis over 100
lesions were identified in the skeletal remains from what appeared to be
projectile weapons. Examining the
mortality curve of the individuals in the cemetery showed that it was
consistent with multiple burials rather than a single event. The stone artifacts examined were consistent
with spear or arrow heads. Some we designed to kill by lacerating and causing blood loss. Some were discovered embedded in bones, but others
were discovered within the area where the body was discovered and that was
viewed as being consistent with the ability to penetrate the body. The authors conclude that the majority of people
in the cemetery died of blunt or sharp force trauma and that there were
multiple episodes of interpersonal violence.
Some of the combatants had been wounded multiple times prior to
death. They also concluded that these
episodes were most likely the result of “skirmishes, raids or ambushes” likely
related to territorial disputes that may have been affected by the weather. (p.
9).
What can be inferred from this long history of human
violence and aggression? First, groups of humans have been perpetrating violence
against one another since prehistoric times. Second, during these episodes total
warfare was very common and the human cost of war is always high. The estimated
percentages of deaths in ancient society were generally higher than in modern
society for a number of reasons. That was not a deterrent to ancient humans. Third, the psychological states during these
episodes of violence show a potentially broad range of thinking leading to aggression. Very limited incidents such as the theft of
livestock or a rumor of a sexual affair between members of different tribes or villages may be all that was required to start a series of retaliations leading
to all out war. Once a violent conflict
ensued – there were thought patterns and rituals in place to justify the
killing, prevent bad outcomes for the killers, humiliate the dead, and
embarrass their families.
The current moral crisis in America seems to have a direct
link with prehistoric behaviors. It is enacted by aggressive behavior that is
described as racism, antisemitism, and gun violence, but the dynamic is the
same one described in ancient man. In
other words, once a person can be seen and characterized as an enemy (for whatever
reason), it is very easy to vilify them,
attribute the worst possible motivations to them, and use that as a basis for
rationalizing aggressive behavior. In the past weeks, I saw two elderly Asian
American women attacked at a bus stop by a man wielding a knife. The attack as
so violent that the large blade of the weapon broke off inside the body of one
of these women. In a more recent event, a heavily armed long time employee shot
9 of his coworkers and then killed himself when he was surrounded by police. In both cases, the “motivation” for the
violent behavior is unknown. There is a
suggestion of mental illness, but the majority of people with diagnosed mental
illnesses and even the same diagnoses are not violent or aggressive. The sheer
volume of mass shootings in the United States suggests it is more of a cultural
phenomenon here than anywhere else but that is confounded by the easy
availability of firearms. The main difference between modern and ancient times is that we have a societal structure that is designed to contain violence and aggression and prevent larger outbreaks. It is clearly ineffective at this point in preventing violence.
I am suggesting a common thought process here that does not
require any psychiatric diagnosis and one that can be intervened upon and self-monitored. In order to perpetrate discrimination, hate
crimes, and even homicidal violence toward others 3 conditions have to
exist. First, the potential victims of
violence need to be seen as sufficiently different from the perpetrator so that
he can attribute unrealistic negative attributes to them and rationalize his aggressive action. Second, the attacker can see himself
as sufficiently different from the potential victims that he feels threatened
by them and can rationalize attacking them for that reason alone. A common example is that the attacker feels
victimized by his coworkers and feels the need to strike out at them. And finally, the attacker must have a plan to
either seriously injure or kill the victim(s). All of these thought patterns can
be considered derivative of thoughts present in ancient man leading to the wide
ranging aggression and warfare described in the references.
I think there is much to be said for intervention based on
the observations in this post. For the
time I have written this blog, I have advocated for intervention based on homicidal
or aggressive behavior. When I worked as an acute care psychiatrist – treating
violence and aggression was easily half of my job. If we can suggest that persons with suicidal
ideation or self-injurious behavior contact a crisis intervention service or
hotline – why don’t we have a similar suggestion for people with homicidal
thinking? And further what about general
education about the primitive origins of these thought patterns. Just the other day I posted the following:
“Ridiculing people who died of C-19 and were
antivaxxers and anti-maskers is bad form - plain and simple.
Bring civility back and restart civilization.
It starts with recognizing the value of a
single human life.”
There was much agreement with the post, but also several
people who suggested that I was naïve for not being able to recognize enemies
or that I was a “better person” for being able to overlook the behaviors of a
group of people who were potentially dangerous to others. My post was not about moral superiority or not
recognizing enemies – it is all about the fact that disagreement should not
lead to enmity and beyond that we are all members of the same tribe. We all came from Africa. And seeing
differences between us that do not exist is probably ancient thinking that obscures
the fact that we are all a lot more similar than we are different. As I explained to some of the critics of my post, they seemed to be focused on the exceptions rather than the rule. They also seemed to be making arbitrary exceptions based on seeing more differences than similarities.
We are currently at a crossroads in this country. People are making money and generating political capital by emphasizing differences and exploiting the primitive thinking that I have outlined in this post. Much of the aggression plays out at a symbolic level in social media, but the Insurrection at the Capitol building and the increasing levels of physical violence illustrates that it is far from always symbolic. Americans have traditionally left ethics and morality up to religious institutions where it may be presented at an abstract level.
It is time to get back to the basic premise of why every person is unique and needs to be treated with respect by virtue of being a member of the human race. It seems like an obvious but untested approach to reducing interpersonal violence at all levels in a society that is not currently equipped to prevent it.
George Dawson, MD, DFAPA
References:
1: Lawrence H.
Keeley. War
Before Civilization. Oxford University Press, 1997.
2: Crevecoeur I,
Dias-Meirinho MH, Zazzo A, Antoine D, Bon F. New insights on interpersonal
violence in the Late Pleistocene based on the Nile valley cemetery of Jebel
Sahaba. Sci Rep. 2021 May 27;11(1):9991. doi: 10.1038/s41598-021-89386-y. PMID:
34045477 (Open Access).
3: Knoll JD, Pies RW. Moving Beyond "Motives" in Mass Shootings. Psychiatric Times 36(1) Jan 13, 2019. Link
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