Strange Contagion

by Lee Daniel Kravetz

  Meanwhile, the train passes through Silicon Valley, and the suicide rate in the town of Palo Alto, caught in this seemingly endless loop, is on its way to rocketing five times beyond the national ten-year figures.

  After lunch, Habib takes me on a tour. I fall for the campus immediately. The buildings of Gunn High, trim the color of jasper, roof of faded shale, are separated by walkways open to the sky, to the fog moving across smoky-green trees, to the traffic sounds off of Foothill Expressway. The school merges so perfectly with the hinterlands, the surrounding flat houses built cheaply, as was the sensibility of their 1950s construction when energy was inexpensive and copper was in short supply, then updated over the years with state-of-the-art accoutrements.

  We lean against a short retaining wall in one of the concrete quads. From there, we watch masses of kids fill every open space, some in large roving huddles, others walking alone, heads down, feet working fast to get to their classes on time. There are so many things that neither Habib nor I want to acknowledge. Our natural response is to pretend that everything will be fine, to ignore the worry and the risk and to believe things will work out, because this town is all about solving seemingly unworkable problems. And it will figure this one out as well.

  Despite this faith, I feel the great weight of regret bare down on my chest as the students move across the campus. Beyond my journalist’s penchant for analysis, I personally need to understand if there’s a solution, an aspect of this monster we just aren’t seeing yet that might clue us in to its vulnerability. I want to know that these students are going to be safe. I want to protect my son.

  If Habib thinks about the five deaths for too long, the self-assuredness in his eyes fades, his stare grows distant, and his lips tighten. While he’s not clear what’s causing his students to harm themselves, he does believe the situation is a creature of Silicon Valley’s own making, a golem constructed out of the region’s best and worst qualities. It recalls for me the writing of Anne McWhir, who scrutinizes the manner in which the author Mary Shelley fashions a creature of resurrected flesh and organs and bones, a train wreck of disparate bodies connected as a whole, and whose knowledge of the world comes by “reiterating” and “replicating” the behaviors around it. “In the process [the monster] may teach us something . . . about our own situation as teachers and as students.”

  Above all, if children acquire their knowledge by reflecting the world around them, then unconscious mirroring is how we learn to be human, how we learn to live. What kinds of examples are we setting?

  The unconscious is the realm in which all of the elements that make up this strange contagion event operate, under the surface, just beyond our awareness. Each component soundlessly shuffles from person to person and spreads at exponential rates with chilling and extraordinary consequences. The unconscious is also perhaps the most divisive and revolutionary theoretical concept since the Babylonians added zero to the Sumerian counting system.

  Unconscious mirroring is much more than intuition, instinct, or even sympathy, which are based on what we speculate others might be experiencing. Rather, social contagions are perfect emulations of others’ thoughts, behaviors, and emotions. It’s the difference between empathizing with a friend’s feelings of joy, and actually experiencing the same sensation of warmth, an accelerated heart rate, and a release of endorphins ourselves. Yet I find the most fascinating, and at once the most unsettling, part to be that we have no idea we’ve caught these experiences, or that they are running our lives in the background like a computer’s operating system.

  The unconscious suggests a separation between awareness and a far more powerful process that runs in the shadows. The unconscious is automatic. It’s instinctual. It provides insight into almost everything we do and everything we believe we know about the world. It is the oldest knowledge our minds possess, a vast and mysterious collection of memory. “What we find is that our brains have colossal things happening in them all the time . . . ,” writes the neuroscientist David Eagleman. “Most of what we do and think and feel is not under our conscious control.” Maintaining the conscious self, he explains, is vital but merely a fraction of the mind’s responsibilities. Instead, it focuses much of its energy on monitoring our inner lives.

  Yet a rich history exists between the invisible, unknowable unconscious and those trying at once to define and to access it. Early characters in the narrative of modern psychology, such as the physician and physiologist Wilhelm Wundt, believed that the mind perceives its own processes. But the late-nineteenth-century physicist Hermann von Helmholtz championed the theory that the brain is more than meets the mind’s eye. Consider how the theater lulls its audience into a trance of false perception, how it convinces the mind that characters on the stage are real, how its representations induce in us genuine weeping and laughter. This separate and unknowable part of the knowing brain, he claimed, was the work of the unconscious. When Sigmund Freud created a topographic map of this ancient edifice, he further delineated the conscious, the unconscious, and the preconscious to justify how the mind operates outside of its own grasp. Salvador Dalí and Max Ernst claimed to have tapped the unconscious in order to create surreal and odd biomorphic dreamscapes of cracked eggs, insect carapaces, headless bodies, and disturbances in nature. John F. Kihlstrom at the University of California, Berkeley, and other explorers of the unconscious mind now suggest that subliminal perception, implicit memory, and hypnosis can access it.

  The unconscious, contend some, thinks only in the present. Others suggest its lens lacks the sensitivity to distinguish the line between fiction and reality. Still others define the unconscious as a monitoring system, the National Security Agency of our inner world that observes every experience we have and records even while we sleep, or as a guidance system, an enhanced GPS that feeds us maps and also tells us where to go.

  And now there are those who suggest it is the reason why five kids from a rich suburb in Northern California jumped in front of oncoming trains: social contagions of desperate ideas, fatal behaviors, and diverse emotions tapped the unconscious through subtle cues and neurological triggers.

  All of this leads to an inescapable understanding that there’s certainly more beneath the surface feeding this strange contagion. Perhaps, I figure, the unconscious has a role to play in stopping it as well.

  Chapter 5

  A Quest in Earnest

  Not long after my visit to Gunn High, I place a call to Yale University. The Human Nature Lab there has taken the lead in making some of the most significant findings on social contagions to date. Nicholas Christakis, the lab’s director, entrenches himself in the study of the interplay between them and the people they infect.

  It’s difficult to quantify how much of what we do is achieved by our own volition versus what we unknowingly pick up from others, he tells me, his voice low and steady. We can’t comprehend, for instance, the number of social contagions we pick up in a given day, let alone across a life span. Notwithstanding, the outcome of Christakis’s decades of research shows that social contagions are so powerful that they shape the landscape of every domain of our lives. And this hidden system of influence, he says, connects us all.

  Along with his collaborator James Fowler, Christakis suggests in a wide-ranging report on networks and human behavior that thoughts, behaviors, and emotions have flow. Their influence spreads beyond a single person to affect many others within relative proximity to one another. Using observational regression-based models and actual experiments, they have proven not only that social contagions happen but also how they happen, influencing everything from voting behavior to public health interventions.

  For instance, in one experiment they mapped hundreds of village households in Honduras and discovered a connection between those who tangentially observe violence and those who go on to perpetrate it themselves. In another experiment, they identified seventy-five villages in rural India and delineated the specific types of social influence that led communities to ad
opt the use of hygienic latrines. Through these and other cases, they’ve also shown that peer effect and interpersonal influence spread kindness, alcohol addiction, loneliness, and even political mobilization.

  “What we know about the connectedness of people on the planet would suggest a kind of global influence of a single individual that seems very implausible,” they observe in their study of social networks and human behavior. Yet the phenomenon is far more plausible, and common, than we often realize, Christakis tells me today. Some lead to negative consequences. Others are incredibly beneficial for us. One social contagion causes people to “catch” smoking. Another allows people to unconsciously catch cooperation. There are others still that manipulate economic growth and personal wealth. Most important, social contagions afford people immense power over others. This includes the ability of a person to project, and of others to catch, qualities that, in some, counter that supreme instinct to survive.

  I know that exposure to suicide alone does not make the act of taking one’s life spread. Psychiatrists have alluded to the contributions of environment and personal temperament as other potential factors. They’ve also implicated treatable mental health issues and cultural communication barriers. When one takes into account the added influence of interacting thoughts, behaviors, and moods flowing across personal networks, one begins to witness a cascade of mounting factors that can become crushing.

  Despite the dangers inherent in some social contagions, Christakis has learned to recognize all of them as connectors of life rather than the erosion of it. Citing the universities of Yale, Harvard, and Pennsylvania, he reminds me that happiness connects people by up to three degrees of separation, and that a sad acquaintance doubles our chances of becoming unhappy ourselves. Secondhand stress connects first responders to victims. Psychologists share the nightmares of the Holocaust survivors they treat. Post-traumatic stress disorder cascades across no fewer than three generations, connecting people to a single event by more than a century. In the workplace, stamina connects employees in collaboration efforts and alliance building. Social contagions among members of sports teams connect players in camaraderie and bring about better game results.

  I consider this deluge of information, adding each fragment of imparted knowledge to the stockpile I’ve been amassing since last summer. My eyes slide over a question I’ve jotted in the margin of my yellow notepad.

  I ask Christakis outright if Silicon Valley has, with its unique proficiency at producing things that catch, the ability to create a cure to help Palo Alto defend itself against this unprecedented strange contagion event.

  He reflects on this for a moment. He doesn’t have a definitive answer, though. Instead, he tells me that the best evidence he’s seen suggests there’s a chance, and that it is certainly a question worth exploring.

  As a kind of structure for this exploration, he encourages me to look at other strange contagions outside of Palo Alto and examine the ways in which people have caught, contained, and treated events in the past. Somewhere, someone has asked the same questions I’m asking. Somewhere, others have struggled with strange contagions. Somewhere, people have grappled with them and have found solutions.

  Part II

  The Perfect Model

  “Children have never been very good at listening to their elders, but they have never failed to imitate them.”

  ―James Baldwin

  Chapter 6

  How to Start a Contagion

  The international code for London leads to a busy signal and then to a wrong number. Finally, after a series of electronic beeps, a delicate and bookish voice answers the line. I feel capricious and hesitant knowing I’ve connected with the British psychologist Gerald Russell, who started one of the most significant strange contagion events in history: bulimia.

  Christakis had suggested that I reach out to him, and it doesn’t take me long to understand why. Like our own strange contagion, Russell’s involved young people, accusations of parental pressure, and problems with media exposure. Like Palo Alto’s strange contagion, an eating disorder comprises many different social contagions. Oxford University identified eating disorders as one part idea contagion, proliferating thoughts and skewed beliefs about body image and perfectionism. Bard College found that they are also one part behavioral contagion: they spread the act of starvation and nutrient depletion. The University of Minnesota described eating disorders as one part emotional contagion, spreading feelings of helplessness, hopelessness, anxiety, and depression.

  For a while, Russell and I speak about the nature of eating disorders and the unique portal to history they offer. Triangulating regions, trends, and cultures, he takes me back to 700 BC, when wealthy Romans facilitated endless feasting with occasional purging. In eastern deserts, ancient Egyptians expunged their bellies to avoid illness. In China, dynasties practiced dangerous food restriction. The path leads to the plains of Africa, where tribes dieted to the point of near starvation. Arriving at the sixteenth century, women plagued with wasting disease were burned at the stake. Throughout history, the transmission of eating disorders was often tied to religious and cultural extremes. Pious European women during the Renaissance limited their food intake to reach a higher plane of spirituality. As the cultural rebirth came to an end in the late seventeenth century, physicians and psychiatrists recorded an uptick in young women who appeared as “skeletons clad with skin.” Two centuries later, researchers suggested anorexia was the result of hormone imbalances, endocrine deficiencies, tuberculosis, or a pituitary issue called Simmonds’ disease. Presenting at the Clinical Society of London in October of 1873, Sir William Gull said that eating disorders primarily affected women with dysfunctional families, a position that by 1930 evolved to combine emotional, biological, and cultural components.

  “That’s where I stepped in,” says Russell with jovial heft. In 1972 a woman checked into London’s Royal Free Hospital to be treated for anorexia. “I found her symptoms to be unique. They didn’t match the diagnostic criteria for anorexia at all.” Unlike his emaciated patients with sallow skin and big eyes, Russell’s new patient was of average weight. Her face was full. Her cheeks were pink as the skin of an onion.

  She was the first of roughly thirty instances of this unusual condition that crossed the threshold of his clinic over the next seven years. Each person presented with perplexing purging behaviors secondary to binge eating. Russell wasn’t dealing with anorexia nervosa, he realized, but something as yet undefined by psychology or medicine. In fact, he had stumbled upon a condition that science had yet to see in large numbers or identify at any time in the long history of eating disorders. Psychological Medicine published Russell’s ensuing paper on these unusual cases. In it he described the key features of this novel mental illness he was now referring to as bulimia nervosa. Many in the scientific community objected to Russell’s conclusions, pointing to the limited and problematic sample size he’d used. At the time, however, there were simply too few cases for Russell to draw from. The pool in the 1970s was just too small.

  As bulimia gained further diagnostic legitimacy in 1980 with its inclusion in the third edition of the Diagnostic and Statistical Manual of Mental Disorders, Russell ruefully tracked its unexpectedly swift spread across Europe and North America, where it infiltrated college campuses, affecting 15 percent of female students in sororities, all-women dormitories, and female collegiate sports teams. The disease moved through the halls of American high schools, where binging, fasting, diet pill use, and other eating disorder symptoms easily clustered. He chased its dispersion across Egypt, where the number of new cases grew to 400,000. In Canada, it swelled to 600,000. In Russia, 800,000. In India, 6 million. In China, 7 million. In the UK, one out of every one hundred women was now developing the disorder.

  “It makes you wonder if maybe bulimia wasn’t a new eating disorder, that it was always there and people just didn’t notice it or talk about it before your paper came out,” I offer.

  Russell demu
rs politely. If the hidden afflicted numbered as overwhelmingly high as they now seem, surely the condition would have made itself known well before he—or anyone, for that matter—identified it. “You might suggest it required somebody to come along and put two and two together before people felt safe talking about bulimia, but I don’t believe that. Until then, the disorder was extremely rare. But after 1980 it became widespread in a very short period of time. Once it was described, and I take full responsibility for that with my paper, there was a common language for it,” he says. “And knowledge spreads very quickly.”

  With this knowledge, Russell’s discovery took on characteristics of a pandemic that was set to claim 30 million people, but neither he nor anyone could do a thing at that point to stop it. He was confronted, he says, by a problem of entropy, a gradual decline into disorder with devastating implications for social contagions: once they are out, they are virtually impossible to rein back in again.

  Even so, a single academic journal article and a mention in a dense diagnostic manual read mostly by psychology professionals doesn’t quite explain to me how bulimia leapt from a few isolated cases to infect people across the globe. Russell agrees: we are missing a critical connection between academia and everyone else.

  Following the debut of bulimia nervosa in the DSM-III, the University of Chicago put out a press release publicizing its own rather novel data on a kind of sequela of anorexia. Mademoiselle and Better Homes and Gardens, among other popular women’s magazines, took the press release and described the effects of a new “binge-purge syndrome” making inroads into American culture. With Russell’s data proliferating among diagnosticians, and the term itself entering the lexicon through trendy magazines with wide distributions, cases of bulimia rose steeply. Once people realized they were able to eat whatever they wanted and as much as they wanted without a weight consequence, binging and purging became the new strategy for weight management. It was no coincidence that these unhealthy and harmful behaviors took hold at the same time that obesity—which Christakis and Fowler have found to be as contagious as any eating disorder—doubled in the US.