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Lonely Apes Die—A New Psychotherapy for Chronic Depression and Anorexia Nervosa

Lonely Apes Die—A New Psychotherapy for Chronic Depression and Anorexia Nervosa

By Thomas Lynch, PhD, University of Southampton (UK)

What do lonely apes have in common with a method that offers help to people who suffer from chronic depression, recurrent anxiety, autism spectrum disorders, or anorexia nervosa?

The answer is that humans and apes are both tribal by nature. Indeed, apes survive only for days or weeks after being separated from their tribe and when humans feel cut off or isolated from their community they are more likely to commit suicide. Our technological success as a species has made it easier for us to overlook our tribal nature.

When compared to other species, humans are not particularly robust—at least when it comes to pure physicality (i.e., we lack sharp claws, horns, thick hides, or protective fur). Yet, since we have survived (and thrived), our physical frailty is proof that our survival depended on something more than individual strength, speed, toughness, or technological know-how.

Our survival hinged upon the capacity to work collaboratively and share valuable resources with members of our tribe who were not in our immediate nuclear family. This required finding a means to bind genetically diverse individuals together in such a way that survival of the tribe could overpower more primitive, selfish response tendencies linked to survival of the individual.

A core component of this binding process involved the development of self-control and capacities to delay gratification in order to achieve long-term goals. For example, self-control capacities enabled a person to not immediately consume valuable resources and instead save them for a rainy day. Not acting on every impulse (another example of self-control) allowed us to work together in groups without the fear of an attack for a minor social conflict.

Indeed, self-control is often equated with success and happiness—and failure in self-control characterizes many of the personal and social problems afflicting modern civilization. Yet, emerging research shows that too much self-control can be equally problematic. Excessive self-control often results in social isolation, poor interpersonal functioning, and severe and difficult-to-treat mental health problems, such as anorexia nervosa, chronic depression, and obsessive-compulsive personality disorder. These “overcontrolled” individuals are perfectionists who tend to see mistakes everywhere (mostly in themselves) and work harder than most others to prevent future problems from occurring.  The problem is that they are unable to let go of control even when they desperately desire to do so and they struggle to form long-lasting intimate bonds that are essential for emotional well-being. Thus, overcontrol works well when it comes to sitting quietly in a monastery or building a rocket to fly to the moon, but it creates problems when it comes to social connectedness.

When you're lonely, it’s hard to feel happy no matter how much you try to change your circumstances.

However, self-control is only part of the evolutionary story. Humans also needed to develop a means to signal to other members of our species who were not part of their nuclear family that we meant them no harm. Humans (in contrast to other tribal species) have developed a unique way to enhance our group strength, i.e., individual tribe members viscerally experiencing others as themselves—a core feature of a new treatment my research team and I have developed specifically for disorders of overcontrol known as Radically Open-Dialectical Behavior Therapy (RO-DBT). By shutting themselves off from their environment, sufferers condition themselves to stop absorbing new information. They perceive new or unfamiliar situations as dangerous rather than rewarding—and their habitual tendency to mask inner feelings makes it much less likely that they will seek or receive the help they may desperately need.

An overcontrolled client is likely to walk into a rose garden and notice the thorns but not the beautiful flowers. Core bio-temperamental (genetic) differences between people may help explain why so many of our treatment approaches have proven to be less effective in treating overcontrolled problems—that is, you cannot simply do, think, or accept your way out of a brain-based behavioral problem.

As a consequence, RO-DBT differs from other treatments—rather than focusing on changing how one thinks or behaves—it teaches patients how to activate areas of their brain linked to social safety and openness to new experience, and to use non-verbal social signals that enhance social connectedness. While building upon a number of core principles in standard DBT, the principles and strategies in RO-DBT are often substantially different. For instance, RO-DBT contends that emotional loneliness represents the core problem for overcontrol, not emotion dysregulation (see additional differences between RO-DBT and standard DBT).

An overcontrolled client is likely to walk into a rose garden and notice the thorns but not the beautiful flowers.

Although our evolutionary heritage may compel us to care for our children or members of our family—this is not what makes us different from other animal species. Our humanity is not about our superior intellectual capacities or opposable thumbs. What makes us unique is our capacity to love someone who is different from us. Indeed, our capacity to form long-lasting bonds and friendships with genetically dissimilar individuals is posited to have been a key part of our species evolutionary success.

When you're lonely, it’s hard to feel happy no matter how much you might try to accept, reappraise, or change your circumstances, keep busy, exercise, or distract yourself. In the long run, we are tribal beings—and we yearn to share our lives with other members of our species. It is what we were born to do.

 

Thomas R. Lynch, PhD, is the treatment developer of Radically Open-Dialectical Behavior Therapy (RO-DBT)—a new transdiagnostic treatment approach for disorders of emotional overcontrol, informed by 20+ years of clinical research. Dr Lynch is currently Professor Emeritus in the School of Psychology at the University of Southampton, and before that he was the Director of the Duke Cognitive Behavioral Research and Treatment Program at Duke University (USA) from 1998-2007. His upcoming books on Radically Open Dialectical Behavior Therapy will come out early 2018.