Why did humans begin clothing themselves? I haven’t consulted Yuval Noah Harari on the subject, but I have my own theory.I don’t think it was for warmth, especially if clothing originated when our ancestors were still confined to Africa. My guess is that humans began using clothes to stylize themselves, perhaps to denote class or kinship. Unlike all other animals, naked humans, once upright, had their genitals on very overt, quite prominent display. Maybe they just needed to relieve the sight of so much junk. And add a spin on.Evidence of jewelry has been found with 400,000-year-old human remains. Would anyone wear a necklace without some outfit to complete the look?Evidence of my own interest in clothes began when I was five and standing alone for a photograph, wearing a boy’s version of a military uniform with a leather strap that diagonally crossed my chest. That outfit showed me a new sense of identity, a kind of mirror reflecting me, the person, someone I might get to know. In the 60s clothing achieved a radical emergence with the tenor of my times.  I was young enough to be swept up into the cause—personal freedoms wrenched out of the stiff, stern, short-hair 50s.I managed to lose my chinos and cordovan shoes, my button-down oxford shirts, my sports jackets, and those foulard ties. They were replaced by jeans, tie-dyed t-shirts, sneakers, and wooly sweaters. Sexual experimentation and macrobiotic diets led the way. But I had done my sexual experimenting in my teens and brown rice with millets would not go down. I also let my hair grow into a massive, Afro-like tangle.I liked being free of the jacket-and-tie look. But then I graduated from medical school. The residency program that took me out of neurology was so advance-guard, so committed to the idea of re-shaping psychiatry, so much a product of R.D. Lang and the community spirit of the hippies and Gregory Bateson’s theory of the double bind and general systems theory..

"Fashion as a creative craft, even art form, seems to have emerged in the West during the 14th century"

 Jackets and ties were disparaged in that program, housed in an abandoned post office building, renamed the Tremont Crisis Center. The model worked. Early intervention and massive support to the family and the community markedly reduced the need for hospitalization. And prevented the worse manifestations of schizophrenic psychosis. Until drugs and the functional MRI made psychiatry yearn after evidence-based medicine.Deinstitutionalization, poorly funded and without community-based treatment, became disparaged and abandoned.I was in analysis at the time. The jacket-and-tie theme emerged as a revolt against my father. He was a middle-class version of a dandy. When he retired to Florida his wardrobe shifted to entire outfits in colors like turquoise—shirt, pants, shoes, socks.I was delivered from my down-dressed look in revolt against that Oedipal revolt. Just in time to open my practice and assume the job of director of residency training. I started buying jackets and ties. I even checked into GQ for fashion hints as well as for the fascinating photographs of Bruce Weber. At first my wardrobe was overseen by a gifted young salesman at Rubinstein’s, a long-established men's clothing store in downtown New Orleans. He would send entire outfits, always rakish but in very good taste. Eventually, I took over and began clothing myself.At my gym I met a young runner, a guy who does 10 miles every morning and runs every marathon and mini-marathon in New York and almost all major marathons in the US. He works at Barneys, a very upscale clothing store that specializes in high-end labels. It is there where my understanding of clothing as fashion was fully (near fatally) fulfilled.Fashion as a creative craft, even art form, seems to have emerged in the West during the 14th century when variations in shaping clothing and tailoring began. Fashion has always most acutely, and most expensively, been elaborated for the elite classes. Lesser social classes followed and imitated, but the wellspring has always come from above.In past centuries high fashion featured furs like ermine, velvet, silk, and much hand-worked detailing like embroidery, tatting, braiding, and beading. Clothing construction probably reached an apex with corsets, crinolines, hoops, flounces, and layer upon layer.Then the manufacture of clothing began, in the last quarter of the nineteenth century. Fashion took a leap forward as copying of couturier design became a feasible industry.Women’s and men’s fashions began following separate paths probably in that 14th century period and has continued differentiating drastically. But crossovers also began to occur and continue. Women got into pants and men into skirts and some flamboyance. Prison and workman’s clothing also grew a style.And what are you wearing?