Boris Cyrulnik is known for popularising the concept of resilience, a term that refers to the ability to bounce back after a traumatic event. The neuropsychiatrist discusses the pandemic, its consequences and its opportunities.
The environment is not a backdrop. Boris Cyrulnik believes that the environment influences cerebral and physical function in humans and shapes how our societies are organised. How has the pandemic impacted our psychological health and society? What opportunities for change has the pandemic made possible? Interview with the French neuropsychiatrist, author of the book Des âmes et des saisons, psycho-écologie (Souls and seasons, psycho-ecology), which came out this spring.
BORIS CYRULNIK / Human domination has produced misfortune but has also enabled humans to survive. In the first major ice age, the human species was disappearing because there were no plants. To survive, they had to heroicise manly violence and develop weapons. The first men thus drove stakes and flint into the hearts of mammoths. Without this violence, humans would probably have died off. The climatic context brought value to violence, death and meat. This organised social relations around male hunters, who were acknowledged and admired. At the same time, this violence produced unhappiness as relationships developed based on domination, especially towards women.
BC / Nowadays, in the West, male violence does not have the same meaning. It destroys the family and society, with 80% of domestic violence cases involving men, and men making up 90% of the prison population in France. However, with technological development, we have developed another form of violence towards animals and nature. We have created huge livestock farms that contribute to the emergence of viruses, which are then spread around the world by our movements. If, after the pandemic, we continue intensive farming practices like the ones I’ve seen at farms in South America, we will recreate the centuries of plagues as in the past, when a new epidemic broke out every three years.
BC / Lockdowns slow the virus down but attack our mental health. Without social relations, our brain deteriorates rapidly. We need others to exist. In children, imaging shows alterations and atrophy in the brain after just a few hours. In adults, people who, before the lockdown, had protective factors – such as a rich inner or spiritual life, a good ability to express themselves, a high level of education and an interesting profession – started reading or took up the guitar again. They came out of the pandemic with relatively little trauma. On the other hand, people who, before the pandemic, had multiple vulnerability factors – such as a little education, a poor ability to speak, an unrecognised or precarious job, and who sometimes live in cramped spaces with several people, emerged from lockdown with anxiety or depression.
BC / It depends on the age. Young children in isolation have everything they need to develop if the mother is there, because otherness is the mother. The lockdowns won’t affect them. Wearing a mask might slightly delay language development in toddlers. But as soon as the mother takes it off, young children recover very quickly thanks to their incredible brain plasticity. This is not the case for teenagers, as they are going through synaptic pruning. This is the process in which the brain functions with fewer neurons but performs better, particularly through learning. If teenagers are isolated from peers and from school, they no longer learn how to learn. They are deprived of a crucial period in their neurological development that cannot be recovered. This is what has been happening in France for the last 15 months. Young people sit numb before screens with which they learn next to nothing, right at the time when their brains are capable of increasingly rapid performance. One or two years of pandemic is huge.
BC / We have a choice. Restrict freedom and go on lockdown, or let a whole swathe of the population die. In history, no lockdown was imposed during the Black Death – a bubonic plague epidemic that broke out in 1348 – but it decimated half of the European population in two years. Without a lockdown, we must accept the freedom to die and kill our loved ones. If we agree to go on lockdown, we have fewer deaths, but teenagers in particular will be impaired in their development. We must remember this dilemma for the future.
BC / Lockdown has shown us how important school is for adolescent development but also as a factor of social protection. In my opinion, once the pandemic is over, we should give greater consideration to the value of school while adapting it to children’s needs. These will be fundamental pathways towards creating a more egalitarian society. I would rein in competition for academic achievement. It is a stress factor that teaches our children to become anxious. Boys drop out of school and girls go through depression. I would look to Finland and develop a less competitive system, without grades. Performance nevertheless ends up comparable, as Finnish 15-year olds achieve similar results to Asians of the same age, with 40% less depression and suicide.
BC / We have managed the crisis well at both the scientific and the organisational level. Lockdowns produced their protective effects, and scientists made extraordinary advances with the development of a new type of vaccine in record time. Never have we experienced anything like this before. At the commercial level in Europe, governments and the pharmaceutical industry have been slow to come to agreement. The crisis has become chronic. Neither health care workers nor doctors have had any respite in the past 15 months. They’re nearing exhaustion.
The pandemic has also taught us that small jobs are not so small.
The crisis has shown us that we need to take care of healthcare workers to keep them from burning out. Otherwise the system will collapse. The pandemic has also taught us that small jobs are not so small. They have played an important role in managing the crisis. Auxiliaries, logistics staff, patient transporters, cleaning staff, and technical employees who update machines all contributed to helping hospitals to run smoothly. These support professions are a protective factor for the healthcare system that we had underestimated.
BC / I hope that the pay increase for healthcare workers, which has been approved in France, will be bolstered by creating more positions and developing continuing education, which is already mandatory for doctors. To discourage them from changing jobs after a few years, they must have career development options. Childcare facilities are also a key issue. Healthcare workers need to be able to do their job with peace of mind, knowing that their children are being looked after properly. This is especially important, as the pandemic confirmed. Early childhood professions play a key role in protecting the development of the youngest children and helping them feel safe, to pick up where parents leave off.
BC / Did you know that we could reduce the number of medical visits and the burden on hospitals by developing protection, education and a sense of security for babies? It is now known that a large percentage of diabetes, hypertension and cardiovascular disease cases are the long-term consequence of a lack of education and poor socialisation in young children. Along with physical immobility, these factors can later lead to the states of depression and heart attacks that fill our hospital wards. At a societal level, good education and childcare must be developed for children from the outset. The way hospitals are organised will be overhauled with more women working in healthcare. In France, 70% of clinic heads are women and we are concerned about a substantial decrease in the number of practitioners, especially general practitioners. Women choose specialisations that allow them to organise their lives well and achieve a good work-life balance. We urgently need to help the younger generation of physicians to choose the paths that interest them while promoting more harmony with their personal life. I come from a generation where physicians worked 18-hour days, had little emotional involvement with their families and were not involved in their children’s upbringing. Physicians’ aspirations have changed, and that’s positive for their psychological balance. Political decisions will have to be made, such as creating more job positions, without raising the price of medical services. We will also have to step up continuing education initiatives for healthcare workers to offset the shortage of doctors in certain disciplines. For example, in France we have a shortage of practitioners. So we hire them from abroad, but they don’t speak our language well. However, our midwives are very well trained and have extensive experience. We could add two years to their curriculum and give them obstetrical responsibilities. In Canada, nurses go on to become medical professors and university deans. At the hospital, as elsewhere, nothing is set in stone, and every crisis brings opportunities.
French neuropsychiatrist, psychoanalyst and university professor, Boris Cyrulnik is the author of some 20 books on neuropsychiatry and attachment theories. Known for having popularised the concept of resilience (rising from one’s ashes), he has gained recognition for his range of work as an expert on the prevention of child suicide or in missions for UNICEF. As a pioneering French ethologist, he emphasises the relationship between human and animal behaviour. In 2008, he won the Renaudot Prize for his essay Autobiographie d’un épouvantail (Autobiography of a Scarecrow). In 2021, he was named Commander of the Legion of Honour.