Coronavirus, moral panic, psychic and physical threat, danger and social immunity

16 March 2020

Graham Music explores the implications of the Coronavirus (COVID-19) outbreak on our mental health and on how we relate to others in light of the pandemic. Identifying the conflation of fear of a pathogen and fear of the other as common, he points out the danger of moral panic and argues for compassion for ourselves and others.

Are we in the midst of a major epidemic/pandemic? How worried should we be? The facts are unclear. The virus is spreading exponentially, but so far death tolls are smallish if tragic, and the worst hit are the most vulnerable groups.  It is hard to know to what extent this is more a disease epidemic or an epidemic of anxiety going viral, although obviously both components are there, and real human tragedy will befall all too many. Even so, perhaps it is worth unpacking some of the evolutionary psychological mechanisms also involved.

All species, including humans, avoid pathogens. There are similarities between the fear response, as seen for example when there is danger of being confronted by an aggressor or predator, and the fear of pathogens. Both give rise to distrust, anxiety, fear of the ‘other’ and other mechanisms such as ‘disgust’ or other animal equivalents. In danger and major stress, brain circuits involved in empathy and rational thought go into abeyance as survival-based responses kick in, including panic and aversion.

Most species, and especially social species, have multiple mechanisms for moving away from pathogens, whether avoiding infected foods, forming colonies near plants that pathogens don’t like, or developing internal group hygiene, such as bees clearing out worrying larvae and ants at times doing the equivalent of ‘deep-cleaning’. Many do what we are doing now, and actively become more isolated.

When we smell something putrid or ‘off’ we tend to feel, and indeed signal, disgust, and whole areas of the brain, particularly the insula, are activated. Smell is possibly the most powerful sense-organ, but sight (eg awareness of other’s worrying bodily signs) and touch etc also are used to detect threat. I think it is no coincidence that trauma victims so often seem to have highly developed sense of smell, especially when the abuse happens at a very young age. Decisions such as what to eat, who to mate with, are influenced by such subtle non-conscious factors.

What we know is that when in a state of stress or when sensing danger, we all tend to be more suspicious and less welcoming of others generally. Indeed, humans seem to have an innately constituted fear of ‘the other’. Even babies prefer others who look like them, talk like them, and act like the trusted adults in their circles.

Social safeness and safeness from pathogens are linked. A classic example is animals' grooming within conspecific groups, whether other primates, or even cats. Those who are groomed and groom have been shown to harbour less infection-inducing tics and parasites. The additional benefit is feeling good. Higher status chimps get groomed more, especially by low-status ones, for example, and grooming fosters a sense of social harmony in which neurochemicals such as oxytocin are released. In humans, we have other mechanisms which foster the same things. Singing, dancing, social and family gatherings, which all heighten oxytocin and immune responses, lower inflammatory ones, and are linked with feeling good. Social outcasts feel pain in the same areas of the brain which activate when we feel physical pain.

I had always assumed that such in-group loyalty and out-group suspicion, even in babies, had a good evolutionary rationale as a main predator of infants and children was often males from another social group who might, for example, kill offspring spawned by other men and indeed, kill those other men too. What I had not sufficiently considered is the powerful fear of the ‘other’ carrying genuinely dangerous pathogens. We know this all too well from the accounts of the genocide of indigenous populations in Australia and the Americas, decimated by viruses carried by Europeans.

Evolution is uneven and haphazard. The same brain and biological systems are involved in a multitude of tasks and purposes, despite the kind of reductionism whereby people suggest that, for example, the amygdala is our fear centre. Danger can be experienced in over-determined ways and there are overlaps between how we respond to very different types of threat.

Fascinatingly of course oxytocin fosters not only in-group trust and cohesion but also distrust of those in out-groups. I again had always assumed this also to be linked to the dangers of attacks from rival groups, but it makes sense that fear of viruses and pathogens is central here too.

It is no coincidence that Trump, in characteristic xenophobic fashion, attacks a ‘foreign’ virus. Pathogens of course are always ‘foreign’ but this conflation of fear of a pathogen and fear of the other is common but dangerous. Certainly, anecdotally it is my non-white clients, particularly Asian ones, who have felt most shunned in the last few weeks. We know from social neuroscience that we can non-consciously demonise certain others, such as the homeless and drug-addicts,  and despite what we consciously avow, often our brains when looking at drug--addicts, or even those of other ethnicities, show less activity in networks involved in empathy and recognising the other as human, such as areas in the medial prefrontal cortex. Instead we often see increase activity in areas of the insula which are linked with disgust signals as well as in amygdala-linked fear reactions. Both also are often activated with a threat of pathogens. The worry is that dehumanisation can kick in, the other becoming ‘vermin’ and ‘subhuman’. Similar brain mechanisms are thus involved in both Trump-like xenophobia, and in fear of pathogens.

I think this links with one of the major health issues of our times, the rise in inflammatory conditions. Inflammation of course is an appropriate response to heal an injury, wound or danger. We need inflammation when we have an injury or when eating toxic food. Our immune antibody army then generally does a great job sending inflammatory cytokines like IL-6, TNF-alpha, CRP, and multiple macrophages etc  in to fight dangerous intruders. However, such immune responses can go into overdrive in disorders such as lupus, fibromyalgia and so much more, and not tell the difference between the benign and the dangerous. The same happens with trauma and other external threats. It is no coincidence that stress, trauma and abuse in childhood are all linked to higher levels of most pro-inflammatory cytokines in adulthood. 

As several authors have recently noted, high inflammation is also central in depression, and anti-inflammatory medications are being mooted as potential treatments. It seems that inflammation might have had a specific evolutionarily important role in managing pathogens and disease, and fevers and hot temperatures have been central to dealing with viruses and other diseases. High inflammation is also linked to social aversion as well as depressive symptomatology, anhedonia, lethargy, likely because social isolation decreases infection risk. High cytokine activity also increases threat responses, hypervigilance and much else seen in psychological trauma. The same genes are involved in both depression and defence against pathogens, genes that are less present in societies where there is less risk of infection, and simultaneously less depression.

Either way, what we seem to be uncovering is an extraordinary synergy between fear of the other, fear of pathogens, expectation of danger and links with the rise of xenophobia, racism and ‘othering’, and links between these and depressive and other metal health symptomatology.

With all this, we also know how poor humans are at accurately appraising the real dangers out there, and can easily mount an over-zealous defensive response or not be alert enough to dangers. Whether lock-down, isolation and banning foreign intruders is the right approach for covid-19 I am not sure, it might well be. However, we need to recognise that this comes with dangers to us as a society, such as discrimination, vigilant distrust, depression and much more.  In response we need to keep alive influences that combat this, whether friendships, family, forms of self-care (for me meditation and yoga and exercise for example). Most importantly we must be alert to keeping alive our capacity to reach out compassionately and kindly to others at a time when such pathways are endangered by heightened threat, fear and disgust reactions, alongside social withdrawal and depressive symptomatology. So, if we need to self-isolate to protect self or others, or be brave and get out there, at the risk of being Polyanna-ish, let’s try to keep hold of compassion, for ourselves and others.


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