Mental Health
May 2, 2024

Thinking about your health beyond eating, exercise and meditation.

I recently read an article “The Emotional Side of Socioeconomic Status” by Laurie Lassiter (2022).  In her article she reviews the research and points out that in both primates and humans there is a reciprocal relationship between the social environment and physiology/behaviour.  Each affects the other.  The nervous system perceives social rejection and stimulates a stress response, which changes genetic expression, thus increasing inflammation and prompting changes in behavior.  These behaviours could be social withdrawal or lashing out, both of which could serve to further decrease social status and increase reactivity to this further lowered position.  This can lead to a vicious cycle increasing stress and vulnerability to illness.  This can occur outside of awareness; my guess is that it most often does.  

Lassiter points out that Socioeconomic status is elaboration of primate hierarchy and is hard-wired in all people. Regardless of one’s values and beliefs about the importance of socioeconomic status, it is a major way that people rank themselves and each other. The ranking itself can occur to a degree outside of awareness while nonetheless having an emotional and health impact.

That in fact one values and beliefs may in part be determined by the social group the belong to.  Being part of one socioeconomic group instead of another may contribute to how much someone trusts others and has optimism. What we may think of as an individual characteristic may be formed at a larger group level. We carry the values, prejudices, and even the genetic expression of our particular social class.  

Subordinate status in society is linked to inflammation and chronic illnesses.  Lassiter (2022) cites research by Tung and her colleagues (2012) who studied primates and found that gene expression leading to inflammation can be induced by repeated social threat.  The more subordinate the animal’s position, the greater the increase in inflammation and poor health. Amazingly they found that if they analysed an animal’s genetic expression, they could predict its social position eighty percent of the time.  

Based on the research, Lassiter states that the social groups we participate in, from the family to socio economic groups, regulate individuals at the molecular level of genetic expression. The stress response activates a genetic expression that promotes proinflammatory cytokines and suppresses the expression of genes that protect against viruses.  She points out that, how the human immune system works is impacted by social position and relationships.  The human evolved through periods of war and peace.  Those who feel rejected and despised have an immune system that prepares them for the injuries of war.   People who feel a part of things and welcome in the social environment have an immune system that protects them from the numerous viruses they are likely to encounter by interacting with many others.  

Lassiter reports that studies suggest that an individual’s social status relative toothers in their community may influence the risk of death. Low social position may be associated with lack of social support, a low sense of control, real or perceived social isolation or discrimination, and feeling less than others.

Given the negative impact of low social status the solution may seem simple: strive to achieve a higher level of socioeconomic status. However, Lassiter sites research that showed that people who focused on increasing income and social status may achieve a high level of personal satisfaction in increasing these, but they still experience the genetic expression of people isolated and living in poverty.  The research did show that those who focus on a noble cause or purpose beyond themselves showed lower levels of the gene expression linked to stress and inflammation. Thus, people who focus on raising their socioeconomic status without a connection to community or to a purpose greater than themselves, may be at risk for inflammation-related illnesses.

This has been of great interest to me as I think about what in our individualistic society, we tend to think that we are in control of as individuals.  That it seems to me that we overestimate our personal control and that of others. That this often leads to stigma and feelings of guilt and shame, that further entrench the stress response.  I question what other important factors and not being considered when the focus on the individual is dominant?

I wonder what would happen if we were able to be more aware of all the significant influences on our health and wellbeing that are not directed by us.  In particular, the influences of relationships.

How often are these factors considered or acknowledged in therapy?

How does this impact therapy?  

I guess that part of the reluctance to look at factors outside of the individual’s direct control is a concern about feeling helpless and a victim of circumstances.  Drawing on Bowen Family Systems Theory I would agree with Lassiter that having a realistic understanding of the factors that contribute to your experience can decrease the sensitivity and reactivity to these experiences. Low socioeconomic status can be less of a determining factor when there is a path forward to manage oneself to increase responsible functioning.

Lassiter, Laurie (2022). “The Emotional Side of Socioeconomic Status” Family Systems Journal of Natural Systems Thinking in Psychiatry and the Sciences. 17.1p9-29.

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