New Books in Anthropology

Steven Lesk, "Footprints of Schizophrenia: The Evolutionary Roots of Mental Illness" (Prometheus, 2023)

Feb 26, 2025

Steven Lesk, a board-certified psychiatrist with nearly four decades of experience, explores the misunderstood realm of schizophrenia in his groundbreaking book. He introduces his 'primitive organization theory,' connecting schizophrenia to our evolutionary past. Lesk emphasizes the importance of integrating evolutionary insights into psychiatry, challenges conventional views, and highlights the impact of historical figures like Paul Schreber. The discussion also covers the evolution of happiness and the complexities of mental health, advocating for a broader understanding of these issues.

01:05:12

Episode guests

Steven Lesk

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Quick takeaways

Steven Lesk's theory posits that schizophrenia arises from recent evolutionary changes, suggesting that current mental illnesses are adaptations to cognitive demands of language.

The discussion critiques psychiatric practices for neglecting evolutionary influences, highlighting the importance of integrating evolutionary biology into mental health treatment.

Deep dives

The Evolutionary Moment and Mental Illness

Mental illness is framed as a consequence of the current evolutionary phase that humanity is undergoing. According to this perspective, conditions such as schizophrenia did not exist 50,000 years ago, suggesting that the way humans currently process thoughts is a result of a transformative evolutionary glitch. Individuals labeled as mentally ill are viewed as those who struggle to adapt to these rapid changes in cognitive function. This hypothesis posits that as society evolves, the manifestation of mental illnesses will decrease, with the belief that in 20,000 years, mental illnesses as defined today will not exist.

Intro

2min

Evolutionary Insights in Psychiatry

16min

The Impact of Paul Schreber's Memoir on Psychiatry

4min

The Evolution of Happiness and Mental Health

13min

The Evolutionary Roots of Mental Illness and Future Resilience

2min

The Influence Machine and Psychological Constructs

9min

Understanding Schizophrenia and Beyond

15min

Of all the mental illnesses, schizophrenia eludes us the most. No matter the strides scientists have made in neurological research nor doctors have made in psychiatric treatment, schizophrenia remains misunderstood, almost complacently mythologized. Without a reason for the illness, patients feel even more alienated than they already do, families are left hopeless, and doctors struggle to provide accurate care. Steven Lesk, though, after a medical career dedicated to those affected by schizophrenia and a determination to find the answer to its existence, presents a groundbreaking theory that will forever change the lives of the mentally ill.

In Footprints of Schizophrenia: The Evolutionary Roots of Madness (Prometheus, 2023), Lesk threads evolutionary evidence with neurological evidence, turning the mysteries of our minds into a tapestry of logic. With his breakthrough theory and this unprecedented book, Lesk will invite necessary cultural dialogue about this stigmatized illness, provoke new psychiatric and pharmacological research, and provide unequivocal comfort to those afflicted and affected by schizophrenia.

Lesk's "primitive organization theory" is based in human evolution, from Neanderthals to Homo sapiens, and the specific changes to our brains after the emergence of language. We have existed in human-like form for six million years, but we've only had language for 50,000; within the vast span of evolutionary time, that's hardly any time at all. Lesk elucidates us to the hormones affected by language, especially dopamine, and with brilliant clarity, connects human evolution, our brain affected by language, and those with schizophrenia whose dopamine doesn't flow in our new, adaptive way. In other words, the twenty million people who have schizophrenia in the world don't suppress dopamine in the way evolution has trained us, so their brains don't process language well and function as if they're in a hallucinatory, delusional dream state. Not only will Lesk's theory focus treatment efforts for schizophrenia, but it will also affect that of other dopamine-related mental illnesses like Alzheimer's, Parkinson's, Huntington's chorea, Tourette's, ADD, and more. Publishing Lesk's work will usher in a new era of psychiatric understanding, one that the field and the public desperately needs.

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