Recent months have yielded increased discussion in popular journalism concerning one of the most significant discoveries in contemporary biology: the microbiome. This term refers to the trillions of microbes that live within every human being, a vast panoply of organisms that interact with our functioning in such a profound way that its alternate term is the “second genome.” Emerging studies of the microbiome demonstrate a complex mutuality between us and living matter that is, strictly speaking, not us. Not only does this refute reductionist notions that “we are our genes” within the realms of biology and genetics, it fundamentally threatens dominant Western conceptions of the self. We are not autonomous beings but a colony of diverse life, a human-microbial collective. Additionally, disrupting the balance of these intertwined lifeforms (such as through the overuse of antibiotics) is increasingly thought to be deleterious to our health.
The idea that (mental) health is defined by a unified self has been a tenet of United States thinking since we first took a stance on the issue in the mid-20th century. Classical Freudian psychoanalysis emphasized incorporating disparate aspects of the psyche into a balanced and reality-based ego, and this aspect became reified during the reign of American ego psychology, as it appealed to our individualistic values that prized the idea that we are in full control of our destinies. From this perspective, health could be achieved in absolute terms when an individual (like the analyst) addressed all defenses against internal conflict to become a truly independent creature, free of neurotic illness and the societal, cultural, and interpersonal structures that caused it. Though this variant of psychoanalysis grew unpopular and has now all but faded away, the “Americanized” attitude toward mental health is alive and well. It is now represented by various interventions, including psychotherapeutic and psychopharmacological treatments, that promise quick and total results based on empirical evidence that is presented as objective and therefore irrefutable. Psychological problems are seen as unwelcome invaders that threaten our cohesion and should be eradicated in the same manner that we eradicate physical infection. However, the microbiome teaches us that this approach is reckless and often harmful, which in turn begs the question as to whether our basic cultural definitions of health and selfhood need revision.
Contemporary psychoanalysis in the U.S. has shifted dramatically from its earlier incarnations to incorporate many of the concepts stemming from object relations, interpersonal, and relational perspectives as well as Eastern philosophies, all of which tend to view the self as less solidified and more transient, or as a multiplicity of states and internalizations rather than a single ego. Within this framework we are not one self but a constellation of self-states that incorporates many ways of being, and that is dependent on context and the presence of others. Selfhood is therefore not fixed or even something to be “achieved,” but a dynamic construction happening in the here-and-now. Relational psychoanalysis and attachment theory in particular argue that the striving for social interaction is a fundamental unit of human existence, and that the idea of an individual self existing in isolation borders on meaningless. (This concept, of course, has been present in non-Western thinking for millenia.)
Acknowledgment of the microbiome makes the idea of a deconstructed self even less plausible. After all, we are never truly alone. Though we cannot carry on a conversation with microbes, we are constantly participating with them. In the most basic physical terms, “we” are located not only in ourselves but in others (trillions of others!) with whom we have a symbiotic bond. Appreciation of this idea in biologic terms should make the concept that the self is intrinsically bound to other non-self entities (such as friends and family, communities, social structures, cultural values, historical trends, and so on) more palatable to the North American sensibility. Likewise, it ought to cast doubt on the “shoot first, ask questions later” approach to treatment, as our very notion of health shifts from purifying the self of pathogens to achieving a harmonious balance within a larger ecosystem that includes both the self and everything connected to it.