The Trouble with Testosterone

by Robert M. Sapolsky

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  Contents

  Introduction

  Acknowledgments

  How Big Is Yours?

  Primate Peekaboo

  The Night You Ruined Your Pajamas

  Measures of Life

  The Young and the Reckless

  The Solace of Patterns

  Beelzebub’s SAT Scores

  Poverty’s Remains

  Junk Food Monkeys

  The Burden of Being Burden-Free

  The Trouble with Testosterone

  The Graying of the Troop

  Curious George’s Pharmacy

  The Dangers of Fallen Soufflés in the Developing World

  The Dissolution of Ego Boundaries and the Fit of My Father’s Shirt

  Why You Feel Crummy When You’re Sick

  Circling the Blanket for God

  About Robert M. Sapolsky

  For my mother, who,

  a long time ago,

  read to me

  Introduction

  We all have encountered Reinhold Niebuhr’s serenity prayer at some point:

  God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference.

  Behavioral biology is often the scientific pursuit of that prayer. Which of our less commendable ways of behaving, asks the behavioral biologist, can we hope to change (and how) and which are we stuck with? Asked in a harsher way—as our society so often poses these questions of nature and nurture—for which of our failings should we be held responsible? Did Charles Whitman open fire from the University of Texas observation tower and kill eighteen people because of his brain tumor? Did Richard Speck murder eight nurses because of his alleged extra Y chromosome? Did Dan White kill San Francisco mayor George Moscone and city supervisor Harvey Milk because of his “diminished capacity”: attributable, in part, his lawyers claimed, to a junk food addiction? Did John Hinckley shoot President Reagan because of insanity? Or were they all just rotten characters? What about the spouse sunk in depression? Is a neurochemical imbalance to blame, or is the person just indulging in a profound sulk? Is the floundering schoolchild limited by a learning disability, or plain lazy?

  In the most narrow sense, behavioral biologists seek to answer questions such as these by exploring the interface between our minds and our bodies. How is it that you can think a thought, have a memory or a surge of emotion—products of our minds—and, as a result, alter the activities of virtually every cell in the body? And, in turn, what are the mechanisms by which events in our bodies—changes in hormonal status, nutrition, health—can change our thoughts and feelings? Answering questions such as these begins to answer the broadest questions of all—what is the biology of what makes us who we are, what is the biology of our individuality, our limits and potentials?

  This is frightening ground to tread, partly because of the complexity of the questions asked. It’s easier to determine how birds navigate while migrating or how muscle fibers contract than to answer a question like “Is there a genetic basis to criminality?” Scarier still are the abuses to which this work is subject. It’s difficult to become an ideologue about bird migration or muscle physiology, but behavioral biology is a magnet for those with an ax to grind. Conscientious scientists fear that a minute observation, tenuously offered, might be seized upon by someone eager to lend scientific authority to claims like “I’m not responsible for my problems,” or worse, “I don’t have to help you in combating your problems, because they are incurable.” At one extreme can be a wasted life, when prejudice dictates that there is a limit that does not exist. Witness those who have been discriminated against by race, ethnicity, or gender because they were believed to be biologically—and therefore, in this view, irredeemably—inferior. At the other extreme, the specter of blame can haunt the blameless, when ignorance leads to failure to recognize a real biological constraint that exists. In that case, witness the generations of dyslexics wrongfully condemned as stupid.

  No matter how obscure the subfield of science, there is bound to be some crazed egghead out there who finds it fascinating. When it comes to the biology of our individuality, issues are raised that should be fascinating to each of us for the simple reason that we are all asked to function as behavioral biologists on some occasion. Most importantly, those occasions matter: We serve on juries and decide the culpability of someone regarding something awful that they have done. We are asked to vote on referendums about expenditures of public funds to try to fix some social ill, and we have to decide if we think it can be fixed. We see someone stymied in their learning, claiming to be at their limits, and we must decide whether pushing them harder represents inspiration or cruelty. And perhaps we will have to watch a loved one decline with some terrible disease, watch their personality be transformed, and have to learn that this is due to the illness and not to them.

  Insofar as we are forced to be practicing behavioral biologists, we might as well be competent at it. This collection of essays is meant to help a bit in that direction in that it offers a tour of the field (albeit a highly unsystematic one, which is to say that it covers a hodgepodge of topics that I’m particularly fascinated by). Broadly, the essays fall into three categories. One group presents some of the latest breakthroughs in psychiatry, neuroscience, and endocrinology. One might assume that much of these findings will be about big, messy problems in abnormal human behavior, about mental illness, uncontrollable violence—the arena of “them and their diseases.” As will be seen, some of the most provocative findings in the field are a lot closer to home, are about far more subtle issues—why we differ in our sexual orientation, in our desire for novelty, in styles of thinking and feeling; this is not about them and their diseases, but about the biology of the quirks and idiosyncrasies of our everyday behaviors. It is my experience from lecturing about these topics that people get fairly disturbed by the implications of some of these findings, as we wind up seeming to have a lot less volition in our behaviors than most like. The extreme example of this is “Circling the Blanket for God,” the final essay in the collection, in which I consider some of the neuropsychiatric roots of religious belief.

  Another set of essays explores many of these same issues from the perspective of evolutionary biology and animal behavior. Initially, many of these pieces will seem to be about how some of our close relatives—nonhuman primates, for example—turn out to be vastly more subtle and complex in their behaviors and emotions than one would ever have guessed from watching Wild Kingdom. What often only sinks in next is not only how subtle and complex they are but how familiar, reinforcing the lesson that we humans are just another primate species: a terribly neurotic, screwed-up, overly self-conscious one with some fancy thumbs, but still just another primate. As but one example of this style, “Primate Peekaboo,” written a year ago when, to my embarrassment, I was devoting about ten hours a day to thinking about the O.J. trial, considers the intense voyeurism that is common to all of us primates.

  Finally, another group of essays considers some of the political or social implications of findings in these areas. Some of these are historical, reviewing some of the disastrous deadends in behavioral biology, some of which are the end-product of well-intentioned mistakes, some the end-product of anything but good intentions. For example, in “Poverty’s Remains,” I recall the history of an imaginary di
sease that was invented around the turn of the century because scientists did not yet know anything about how stress affects the body, and before it was over with, thousands of people were killed by the consequences of medical belief in this erroneous discovery. And some of these pieces are meant to alert us to some of the dangers to come. In “How Big Is Yours?” for example, I discuss some recent and controversial evidence that the size of a certain sliver of the brain has something to do with a man’s sexual orientation and then raise the question—what happens when brain imaging techniques get to the point, as they soon will, where a ten-year-old can be informed as to the size of that silver in his own brain?

  Thus, the ground that will be covered. A final note: I believe that everyone can benefit from learning some science these days, regardless of how efficient a job those teachers did in junior high school convincing us that we hated the subject. When science works right, it is an amazing thing to behold—it provides us with some of the most elegant, stimulating puzzles that life has to offer. It throws some of the most provocative ideas into our arenas of moral debate. And occasionally, it even improves our lives. The subjects contained in here, I feel, have the abundant potential to accomplish all of that; thus, I have made an effort to write these essays so that they will be accessible to anyone, even the card-carrying science-phobic. I think I can guarantee that the facts in here will be relatively simple, and I know I can guarantee that their implications will not be.

  Acknowledgments

  Some of the topics covered in these essays are related to my area of research, and I am supposed to know something about them. In many cases, though, these are about subjects that are not in my area of expertise (which, as will be seen, hasn’t prevented me from developing some addled opinions about them). In these cases, I have been very dependent on the generosity and clarity of some of my colleagues in discussing their work and ideas. I thank Jeanne Altmann, Jay Belsky, Laurel Brown, Jonathan Cobb, Jared Diamond, Bill Durham, Laurence Frank, James Gross, Ben Hart, Charles Nemeroff, Craig Packer, Edward Paul, Larry Squire, Michele Surbey, Andrew Tomarken, the late Amos Tversky, and Richard Wrangham for their assistance; any factual errors are of my own doing.

  I am particularly grateful to the research assistants who helped me with many of these essays—Steve Balt, Roger Chan, Michelle Pearl, Dave Richardson, Serena Spudich, and Paul Stasi. They have been heroic in finding the most obscure of facts in the farthest corners of archival libraries, surfing the Internet for answers to trivia questions, and laboring at odd hours of the night to call experts on the opposite side of the globe. I also thank Helen and Peter Bing, a visionary couple who have made grants available to various Stanford professors for forays into unorthodox teaching initiatives. Most of these essays started off as lectures, and the Bings made the labors of these assistants possible.

  I also thank the teachers who got me into science and, just as much, made me excited about wanting to communicate about science to nonexperts: the late Howard Klar, Howard Eichenbaum, Melvin Konner, Bruce McEwen, Lewis Krey, Paul Plotsky, and Wylie Vale.

  Many of these pieces were originally published in Discover, or in The Sciences, and the writing was often greatly improved by my editors there. It has been a great pleasure working with them, and I thank them all—Burkhard Bilger, Peter Brown, Alan Burdick, Robert Coontz, Patricia Gadsby, Paul Hoffman, Richard Jerome, Polly Shulman, and Marc Zabludoff. Those readers who are familiar with The Sciences will know of the superb artwork that graces its pages; that is the work of Liz Meryman, and I thank her for consenting to read these pieces and give advice on accompanying artwork.

  Walter Bode rather indirectly made it possible for these essays to see the light of day, and I thank him for that. Liz Ziemska, my agent, far more directly made it possible, and my great thanks to her as well. Hamilton Cain and Jennifer Chen have helped every step of the way at Scribner, and it has been a great pleasure to work with them.

  Finally, my gratitude to my wife and best friend, Lisa, for endless numbers of reasons. However, there are special grounds for gratitude with respect to this book—during vacations, during times when she has been struggling with some deadline, during times when she has just been trying to get some sleep; during good times and bad, through thick and thin, in sickness and in health, she has put up with my excited ranting and raving about whichever of these essays I’ve been working on at the time.

  How Big Is Yours?

  Alfredo Castañeda, When the Mirror Dreams with Another Image, 1988; courtesy Mary-Anne Martin/Fine Art, New York

  During my graduate school days in New York City I lived along the East River, and at times when I felt like indulging a simultaneous sense of adventure and melancholy I would visit Roosevelt Island. The island was a sliver of land in the river, two and a half miles long, accessible from Manhattan by a pleasing aerial tramway. Today most of Roosevelt Island is filled with high-rise apartment buildings. But in earlier times it was the dumping ground for various incorrigible or unmanageable members of society. At the very tip of the island are some remnants of those times—the rubble of a mental asylum abandoned in the first half of this century.

  A decade ago it was still possible to climb around in those ruins. You could shin up the banister of a staircase whose steps had long since decayed away, push open creaking metal doors half off their hinges, and enter a room without a roof. You could then tiptoe through a third-floor hallway about to give way and hurtle you through the splinters into the basement (and, you were sure, into a nest of rats the size of pit bulls).

  It was impossible to inch through the debris without being moved by the events that must have taken place in this ghost of Bedlam. There were doors marked INSULIN SHOCK ROOM, rusted gurneys with restraining straps teetering halfway through holes in the floor, and bloodstains on the walls. Even on a warm autumn day with the sun shining on the roofless building, the whole place still felt dank and shadowed, the walls humid with the screams of misery and sadness.

  Contemplating the treatment of an insane person from a century ago is something of a Rorschach test for us. Do we focus on the vast progress that has been made in psychiatry? Or do we see no difference at all from our own miserably inadequate treatment of the mentally ill?

  Some things remain depressingly the same across the centuries: In so many times and places, the mentally ill give the rest of us the willies, and they are carefully isolated and ostracized. Yet many other things have changed. When we discuss treatments now, we think of drugs to manipulate brain chemicals such as neurotransmitters, while in earlier times it was lobotomies and insulin-induced comas, and still earlier, restraint and ice baths. Our notions of causes have changed as well. Now we discuss receptor regulation and genes, while earlier we would have blamed mothers sending conflicting signals of love and hate to impressionable young children.

  What has changed most palpably, however, is our attitude toward abnormal behavior. We have become far more subtle when we consider the thorny issues of blame. Centuries ago epileptics were persecuted for their presumed bewitchment. We no longer do that, nor would any rational person prosecute an epileptic for assault and battery should that epileptic injure someone while flailing during a seizure. We have been trained to have a strikingly compassionate thought that is one of the triumphs of our century: “It’s not him. It’s his disease.” We have been taught to draw a line between the essence of a person and the neuropsychiatric disorder that distorts and constrains that essence.

  We are very good at drawing that line in rejecting the idea that an epileptic is violent because his arms move uncontrollably during a seizure. But we are not particularly good at drawing the line between a person and his disease in many other realms. Witness, for example, the Neanderthal bellowing in so many editorials about how John Hinckley was “getting away with it” when he was hospitalized as a schizophrenic rather than being jailed after shooting Reagan. Or contemplate the number of teachers and parents who are not very good at drawing the line between the essenc
e of who a child is and the learning disabilities that impinge on that essence—and who instead let words like “lazy” or “stupid” creep in.

  If many of us are not very good at drawing that line now, that problem is going to get worse. Some astonishing new trends in neuropsychiatry and behavioral biology indicate that the line will shift in directions we never would have guessed. This shift affects much more than our understanding of the biological imperatives that drive a small group of us to monstrous behavior. It also affects how we view the quirks and idiosyncrasies that make each of us a healthy individual.

  To me, one of the most intriguing changes has occurred in the way we see “schizotypal” individuals. A few decades ago a team headed by psychiatrist Seymour Kety of Massachusetts General Hospital initiated studies that demonstrated a genetic component to the disordered jumble of thoughts known as schizophrenia. The scientists examined adoption records meticulously maintained in Denmark, reviewing the cases of children adopted from their biological parents very early in life. If a child of a schizophrenic parent was adopted by healthy parents, Kety wanted to know, was the child at greater than average risk for schizophrenia? Conversely, did any child of healthy biological parents raised in a household with a schizophrenic adoptive parent have an increased risk for the illness?

  Kety’s work showed that genetics does in fact increase the likelihood of the disorder. But to get that answer, doctors had to conduct intensive psychiatric interviews with the various biological and adoptive parents. This involved thousands of people and years of work. No one had ever studied the relatives of schizophrenics in such numbers before. And along the way someone noticed something: a lot of these folks were quirky. These relatives were not themselves schizophrenic—just a bit socially detached and with a train of thought that was sometimes a little hard to follow when they spoke. It was something mild, and not the sort of thing you’d note in talking to the family members of a few schizophrenics, but it suddenly stuck out when you dealt with thousands of them. They believed in strange things and were often overly concerned with magical or fantasy thinking. Nothing certifiably crazy—maybe a heavy interest in science fiction and fantasy, or a firm belief in some New Age mumbo jumbo or astrology, or perhaps a very literal, fundamentalist belief in biblical miracles. None of these are illnesses. Many adults attend Star Trek conventions, presidents’ wives consult astrologers and are still taken seriously by the fashion industry, and others believe that the earth really was created in seven days. But today psychiatrists call the collection of traits seen by Kety “schizotypal personality disorder,” especially the emphasis on magical thinking and the loosely connected thoughts. Apparently, if you have a certain genetic makeup, you’re predisposed to schizophrenia. Have a milder version of this genetic makeup, and you may be predisposed to placing a strong faith in magical ideas that are not particularly based on fact. Is there a gene for believing in the Force and Obi-Wan Kenobi? Certainly not, but perhaps there’s something closer to it than we ever would have imagined.