Well…there are and there aren’t. If I had seen this title written by someone else, I would have reached into my very large store of “yes, buts” and started replying. In this particular case, I wrote it myself and I know what I meant. I meant that there are no mechanisms that affect society (social) in the way genes affect bodies.
You can, of course, devise analogies to the effects of or the mechanisms used by genes—that is the first thing I did—but there are no such genes. There is no endocannabinoid system, despite those who would nominate NFL football; There are no cannabinoid receptors. There are no FAAH enzymes, although as a political scientist, I am used to assuming that an initial F probably stands for federal and you can do some really interesting things with the AAH if you do start with federal.
There was a really interesting article in last Sunday’s New York Times (here) called “the feel-good gene.” Author Richard Friedman’s point is that the “good gene” is called anandamide; that it is naturally synthesized by our bodies, and that some people have more than others. Those people are “lucky.”
But there is another way of understanding my patient’s anxiety and cannabis use. The endocannabinoid system, so named because the active drug in cannabis, THC, is closely related to the brain’s own anandamide, is the target of marijuana and has long been implicated in anxiety. It exists throughout the animal kingdom, though one would be hard-pressed to find a nonhuman animal clever — or foolish — enough to eat solely for the purpose of stimulating its own receptors with cannabis.The major naturally occurring cannabinoid in our brain is anandamide, something our bodies synthesize. Anandamide is, aptly, taken from the Sanskrit word ananda, meaning bliss because, when it binds to the cannabinoid receptor, it has a calming effect.
This is why articles like these ought to be written by teams of doctors and sociologists. This one was written by only the doctor half of that team. Dr. Friedman has been treating patients and has seen the terrible effects of anxiety levels that are “too high.” And he has apparently been in contact over the years with people who argue that anxiety is a psychological problem (only) and therefore ought not be taken over by people who study genes.
What the sociologist half of the team would have said is, “What is the ideal distribution of anxiety in a society so that the society will be best served by it?” The question at the system level is how much anxiety distributed in what way will be best for the system. I know that would seem heartless to a therapist, but anyone who wants to treat the issue at the system level, as opposed to the individual level, is going to have to be willing to ask that question.
Another question the sociologist who should have been the co-author of the doctor would have asked is, “How much anxiety is too much for this person?” The enzyme FAAH, referred to above, is an enzyme that deactivates anandamide. Anandamide has a calming effect on us—an anti-anxiety effect—so too much FAAH is going to mean more anxiety. We know that and by manipulating the amounts of FAAH, we can manipulate anxiety. But no deftness of manipulation is going to tell us how much anxiety is “enough.” Or is “functional.” Or is better than the alternatives.
Do we need to know those things? Not to treat hyperanxious patients. When a patient comes to see a doctor and is immobilized by anxiety, the doctor’s job as it pertains to that patient is to treat him or her so that the level of anxiety goes down and the level of functionality that we call “living a life” is restored. We need to know who we are talking about (the patient) and what direction to take the anxiety level (down).
But what about other perspectives? What about cultivating resilience? I chose the picture below because it shows precisely what the word means. What about “appropriate levels of anxiety?” Imagine that I keep doing an activity that makes me very anxious. I can wish I were less anxious, but I am still anxious. I can lament that I am not among the 21% of Americans of European descent who have the “feel-good gene.” Or, in some cases, I can stop doing the activity that makes me anxious. That third alternative is the one that attracts me. I know it doesn’t apply to all situations, but nothing applies to all situations and when I hear people lamenting the “bad luck” of the 79% of Americans of European descent, I wonder if the next step isn’t going to be to “change the luck” by synthesizing the “feel good gene” and dumping it into the water supply.
I know that’s a fantasy. In Portland, we can’t even add fluoride to the water supply. But I’ve read Brave New World just like you have and in order to not go there, there has to be a counter-logic. Where is a counter-logic going to come from? Is it going to come from the place that failed to oppose an explosion in the use of Ritalin that is sometimes estimated at 700%?
Assuming that the Ritalin numbers are just a quantification of “alarming increase,” how did that happen? Well, some kids were diagnosed as having ADHD and given medicine that helped them. Good so far. Now the question for the parents of non-ADHD kids is, “If my child would be helped in school by doses of Ritalin, why should I not provide them for him?” Good question.
Here’s another good question. What is “hyperactivity?” This is your sociologist speaking. “Hyper-,” that means “too much” –activity is too much activity for a given setting or for a given task or for a given time. So here’s a thought: change the setting. Modify the task. Allow for a wider range of “normal behavior.”
I don’t know if those would work in any particular case, but they are all instances of translating medical questions into social questions. Social questions have the virtue of preserving a place for psychological questions. Asking whether you have provided a good environment for the children is a really good thing to do, but even after you have, there are kids who are going to be benefitted by drugs like Ritalin and by gene therapy which reduces FAAH.
The social form of the question leaves room for the medical form, but the medical form does not leave room for the social form. And that’s one big reason why I prefer the social form.
 There are ways of framing these things that have a substantial effect on whether they are thought to be social problems or just individual problems. Constance Nathanson’s work on that has produced the categories, medical problem, moral problem, and social problem. Today, I am pitting the first against the third.
 I came to a vote and the people gave a resounding NO to it.