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Archive for April, 2007

Now here‘s and interesting piece of research. Meyers-Levy and Rui Zhu from the University of British Colombia have shown that ceiling height affects the way we think. When the ceiling is higher, people think more abstractly and when it is lower they think more specifically.

Now that’s interesting! Because they are not saying that one particular ceiling height is good and another bad but that the physical environment in which you sit or move will be conducive to a particular way of thinking.

So, next time you want to be creative, think freely, brainstorm, or whatever, maybe you should get yourself into a room with a high ceiling! What about outside I wonder? Is that better? But, next time you want to focus in on the specifics, the details of a piece of work you might be best to find a more tightly enclosed space. Reminds me of something I read about writers who use a garden shed to write in! I wonder if the different kinds of rooms writers write in suit different kinds of writers?

What do you think? Are you aware of the effects that a room’s dimensions can have on your thought processes?

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Ben Ledi

From the window of my apartment I can see across to the hills. One hill in particular stands above the others – Ben Ledi. I got to thinking the other day about how things change, how everything constantly changes, but how if something changes slowly we think its staying the same. You know what I mean. A plant changes quickly, growing from a seed to a seedling and blossoming under the sun’s rays to show its petals to the world, then developing its fruit or its seeds and withering away again, in endlessly repeating cycles. But mountains, now, they change so slowly they look the same for hundreds or even thousands of years. Don’t they? But then, as I gazed out of my window across the fields at the light and the shadow on the hillside, I thought to myself, actually, Ben Ledi looks different every day. OK, the rocks probably don’t change very much, but Ben Ledi is more than its rocks. The Ben Ledi I see from my window is not just the rocks, the slope, the shape of the peak. It’s foliage, the colours, the light and shadow. When I look at Ben Ledi I see something different every day. Here are four (of many!) photos of Ben Ledi all taken from my window.

Ben Ledi just after a storm.

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Ben Ledi with morning mist.

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Ben Ledi covered in snow.

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Ben Ledi in a winter setting sun.

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If you like these Ben Ledi photos you can find more on my Flickr page here.

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Patients’ stories are often dismissed by doctors as being too subjective to be of value. Objective information is rated more highly. In fact the dominant paradigm of the biomedical model is “evidence-based medicine” where a hierarchy of value has been created which emphasises the findings from research trials conducted on groups of patients over the individual stories of doctors and patients. Let’s understand and maybe challenge this hierarchy.
By subjective we usually mean a person’s unique experience. No two people can have identical experiences because no two people are identical. The dismissal of a patient’s story is the dismissal of personal experience.
We tend to think of objectivity as being outside ourselves, as being a phenomenon which is free from individual prejudice, as if it is unfiltered or pure. However, objectivity is actually just a consensus of personal, subjective views.
Take a look around your room now. What do you see? A computer probably! Maybe you can see a chair. Let’s just focus on the chair for a moment. This experience you are having right now of seeing that chair is subjective. It is YOU who is seeing the chair. But if everyone who comes into your room can also see that chair then seeing that chair becomes objective. The observation becomes more reliable in the sense that you could say to a perfect stranger “Come into my room and tell me what you can see” and, amongst other things, the stranger will report seeing that chair.
But subjectivity and objectivity are not mutually exclusive, either/or, categories. There’s a range or degrees of objectivity. For example, what colour is that chair in your room? The answer to that question will vary. Not everyone will agree about the colour of an object because colour sensation is a highly subjective phenomenon. Let’s push this one step further. Is it a comfortable chair? Well, now the consensus will become seriously shaky. You cannot be sure that a stranger coming into your room will describe that chair as comfortable.
The greater the consensus of experience, the more we are likely to call it objective, because we know that there will be a high probability that almost everyone will concur.
However, what matters to me if I have a pain is my experience of the pain. Nobody else can experience my pain. The concept of objectivity becomes irrelevant. If I take a painkiller, only I can tell you if it is working for me. No doctor or scientist knows better than you do about your pain. So claims that only treatments which are “evidence based” ie which work for many other people should be offered to patients are not supportable. Clinical trials (group experiments) reveal useful information about possibilities and even probabilities but they should never be treated as the last word on something. “Evidence” is never complete. However, although a majority of people may claim relief of their symptoms from a particular treatment, we can never guarantee that that treatment will work for this particular patient. Some people will only respond to a totally different treatment, possibly one which has never been shown to help the majority of patients. We should never prevent patients from having the treatment that works for them just because that treatment hasn’t helped most other patients.
How many patients should get relief from a drug before we can claim this drug is “evidence based”? Well,
However, as Dr Roses of Glaxo SmithKline, specialist in pharmacogenomics at Glaxo SmithKline famously said,

“The vast majority of drugs – more than 90 per cent – only work in 30 or 50 per cent of the people,” Dr Roses said. “I wouldn’t say that most drugs don’t work. I would say that most drugs work in 30 to 50 per cent of people. Drugs out there on the market work, but they don’t work in everybody.”

That’s a minority then. This falls far short of objectivity as consensus. Why is that? Because what matters is not just what most people experience but, when it comes to your health, your illness, it’s your story that matters. A doctor can, and should, tell you that a particular treatment has been shown to help a certain percentage of patients but you will decide which treatment to continue with solely on the basis of your unique personal experience. It’s your story, your feelings, your sensations that matter most when it comes to your health.

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There’s a website called Change This. They publish articles which they call “manifestos”. I just came across this one. Nassim Nicholas Taleb argues that unpredictable events are like “Black swans” – until one is seen we lack the imagination to even think such a creature is possible basing our expectations entirely on our previous experience. Taleb says a Black Swan is rare, its occurrence has a large impact, and it is predictable only retrospectively (we explain it with a narrative we make up after the event).

It’s an interesting idea. There’s a phenomenon described in complexity science which is similar to this. It’s called “emergence” and it means the kinds of events and behaviours that occur which are brand new and have never been seen before. For example, when a particular hurricane suddenly starts to behave differently from all previous hurricanes. I see this all the time in patients. There is a terrible tendency in Medicine to focus on diseases rather than the people who have the diseases. Once a diagnosis has been made (the disease has been named) a prognosis is made on the basis of how other cases progressed. But the thing is that again and again patients just don’t comply with statistics. Take Stephen Hawking as an example. He has a disease called Motor Neurone Disease. Usually people die within two years of a diagnosis of this disease. Stephen Hawking was diagnosed over 40 years ago.

People are different. It is impossible to accurately predict an outcome for any single individual with a particular diagnosis. The future is, and always will be, uncertain. That’s not a bad thing, though we crave certainty. I once had a patient who told me her husband had been diagnosed with cancer and had been told he had six months left to live. I asked her how she felt about this and her answer took me completely by surprise (you could say it was a Black Swan!). She said “I’m angry. Very angry. It’s not fair. How come he gets to know how long he’s got and I don’t get to know how long I’ve got?!” I had to explain that actually he might not die in six months time!

But Taleb’s idea about Black Swans makes another interesting point which is about the human use of narrative to make sense of things. Even though an event might be totally unlike any event we’ve ever seen before we’ll do our best to explain it as if it had been predictable all along. This further feeds our tendency to believe in certainty and predictability.

The contemporary practice of Medicine as strongly based on encouraging decision making on the basis of what’s already known (this is called Evidence Based Medicine), but as I once heard Dr Harry Burns (Chief Medical Officer of Scotland) say “If we base all our treatments on what we already know how can we come up with new, better treatments?”

We need imagination. Without imagination we cannot see what might be. Even with imagination however we’ll still have masses of experiences which we didn’t expect. That’s how life is… I don’t want a wholly predictable life. Do you? Understand me here, I’m not saying I want nothing to be predictable. I do want to know that when I catch the 0735 Glasgow train it’s got a good chance of getting me to Glasgow at 0820 (OK, maybe one day!!). I like routines and rhythms. But I like surprises too and the fact that every single patient I see tells me something I’ve never heard before makes my day. Every day.

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It’s time

Time for what? Well, what I’d like to suggest is that you take the time to find out something new about somebody today. I work at Glasgow Homeopathic Hospital and a few months back we had a temp on reception. Her name was Louise Rutkowski. One day over lunch break I got chatting to her and found out that temping was not Louise’s main thing in life. She was a singer and had previously worked with This Mortal Coil. We had some interesting chats about following your dreams and doing what you love in life while also finding a way not just to make a living but to support your dreams. Anyway, recently Louise emailed me and told me she was in the middle of making an album.

Listen to this. It’s called “It’s time”

I love it. On her myspace page she lists Blue Nile and Kate Bush amongst her inspirations. You can really hear that in this song. There is nothing more wonderful than seeing or hearing somebody realise their dreams. This is Louise’s best song ever (IMHO) What do you think?

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There are a number of qualities in complex systems. Let’s have a look at a couple of them and see how they can help us to understand why sometimes we get stuck and why on other occasions we when we get through a certain difficult experience we feel that not only life, but we ourselves, have changed irrevocably.

Attractors

One quality is that of an “attractor”. The one attractor you’ll know something about is the kind that makes “Black Holes” – those whirlpools in space that suck everything, even light, deep into their swirling vortices. There are three kinds of attractor.

  1. Point attractors – these pull everything towards a single point.
  2. Loop attractors – these have two centres close together and anything which comes close gets swept back and forward between the two centres, flip-flopping between two alternating states.
  3. Chaos attractors – a focus of chaos, with everthing that comes near being pulled into a chaotic system.

What can these phenomena teach us about life? Well, a point attractor is the kind of thing that traps us. It might be a wound, a hurt, a bad experience. Or it might be a habit or stuck way of thinking. These are the well-worn paths that always, inevitably, end up at the same destination, producing the same outcome. It’s hard to move on, to grow or to develop when you keep going back or holding on to the same old thing. Point attractors are about stuckness. They produce routines that become ruts.

Loop attractors are those alternating states we often experience – a cycling back and forward between emotional highs and lows, between frantic activity and depression, between fear and anger. There is more variety in a loop than in a point, but they both entrap.

Chaos attractors are the most confusing of all. They hardly seem recognisable. They have no pattern, no rhythm and no predicability. Their only inevitably is chaos. These are the states we often find ourselves in when we are overwhelmed by something – bad news, loss, terror, grief. Like the points and the loops, the chaos attractors trap. At least points and loops have the comfort of the familiar, and, to some extent, the predictable. Chaos states are very hard to experience and can’t be sustained for long.

How can we break free of the pull of an attractor?

  1. Imagination. Developing your powers of imagination generates the potential for change and for movement. Without imagination it can be hard to believe that there is any possibility of breaking free from the entrapment of an attractor.
  2. Will. Determination and motivation. It’s one thing to imagine how life could be different but it takes a strong desire and determination to change to break free of the attractor.
  3. Relationships. Sometimes it takes an external influence to make the difference. This is where other people can make such a difference. It can be the attention, the love and the care of another which helps us to break free from our stuckness, our habits and ruts.
  4. Changes in circumstances. We all exist in constant interaction with our environments. As the environments change so do we. Changes in circumstances like new relationships, the ending of relationships (whether through break-up or death), loss of employment, new employment, moving house, and so on, can all exert huge power to knock us out of the old patterns and stuck places. This is why sometimes painful events can result in significant gains.

Bifurcators

Bifurcators are like crossroads. They are points where things change. With a bifurcator you usually have two possibilities – growing or shrinking. At a bifurcator the system changes and either develops, changes and grows stronger or more resilient, or it declines, shrinking or disintegrating, becoming weaker. The key thing about a bifurcator is that life is not going to be the same again. A good example is pregnancy. Once pregnant, a woman’s life will never be the same. She can never again have never been pregnant. Either the baby will grow and thrive and the woman will become a mother (and how different does THAT make a life!) or the pregnancy will not progress and the woman will experience an abortion, a miscarriage or a stillbirth. In none of these circumstances will she ever be the same again. Often there are no choices possible. Life develops one way, or it develops another. However, in many situations a bifurcator is all about making a choice. The challenges which come our way for example can be accepted or rejected. Accepting a challenge brings the potential for growth. Rejecting a challenge can leave you stuck in the arms of an attractor!

So, here is a key difference between a hero and a zombie – heroes break free of attractors, grasp the bifurcation points and grow; zombies stay stuck at the same points, in the same loops, engulfed in the same chaos, avoiding bifurcators and preventing growth.

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train table, originally uploaded by bobsee.

For over ten years now I have lived over an hour’s commuting time from my place of work. I love it. What I don’t do is drive! Well, sometimes I do, but only if I really have to. I take the train or I take a bus. I should point out that I live in Central Scotland so commuting for me USUALLY means getting a seat. I know in some places commuting by public transport doesn’t include sitting down!
What this gives me is at least two hours a day to myself. I don’t have to do anything. Just sit there and be chauffered by either a train driver or a bus driver. I take my ipod (I’ll blog about that separately!), notebook, book and maybe laptop. I can sit and think, write, listen to podcasts, music, read and reflect, use my laptop. Mostly I have a low-tech commute, drlnking a coffee, reading a newspaper or a book, or using my notebook to jot down ideas, make mindmaps, do a bit of planning.
My commuting time can be for working, for relaxing, for reflecting and for creating.
It’s a gift

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Morning pages, originally uploaded by bobsee.

What makes a space a creative space? Every Saturday in the Guardian there is a photo of a writer’s room. It got me thinking about the spaces which somehow make creativity flow.
A number of years ago I read The Artist’s Way and I two lessons really stuck with me (but for some reason I never got round to carrying them out until recently).
The first lesson was what Julia Cameron calls “morning pages”. Her idea is that you should write, pretty much stream of conscious writing, every morning until you’ve filled three pages of a notebook. Well, I never did it, until 27th December last year. Since then I haven’t missed a single day and it’s almost a kind of addiction now. If I don’t actually do it first thing there’s a kind of irritation in me, a discomfort, until I sit myself down and write the three pages.
I haven’t stuck to writing first thing but most mornings I do get up at 6am, shave, shower, dress, then sit myself down and write the three pages. If I’ve got time left, I have breakfast! I find it takes anything from 15 minutes to just over half an hour to write the three pages. I’m not precious about the stream of consciousness thing but I do try not to stop once I’ve started (I don’t pause for thought, worry about grammar or punctuation).
Sometimes I have written on the train, on a plane, in a cafe or in an airport. The variety gives me a bit of a kick. I let myself just ENJOY it and don’t give myself a hard time for not having written within an hour of getting out of bed. With this leeway, I’ve written 3 pages EVERY single day since December 27th and I really don’t see me stopping now.
I didn’t read what I’d written at all for the first six weeks and I haven’t kept up a time for writing what I’ve written (in fact, most of what I’ve written I haven’t read!). However, my creativity has been unleashed! I can’t tell you just how much but I take more photos than ever before, post up to Flickr for the first time ever, started this bog, wrote a few pages for a website……I could go on. I just feel that ideas don’t rattle around my head like hard peas in a tin any more, rather they come together, they develop and, more than anything, they turn into real world phenomena – words and images mainly.
I cannot recommend this habit highly enough. It is transformative.

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The story so far……
I woke up on the morning of January 1st this year and this word popped into my head “storymapping”. I thought “what’s that?” The word came from a lot of thinking I’ve done about how we experience the world.
My basic premise is this……
We live in a real physical world – an objective shared three dimensional space – but we can only experience it subjectively. There’s no way for me to know how any other person experiences, say, the colour red, or the smell of coffee. But before I even get into thinking about relationships and how we communicate with others and understand each other, let me stay with the single person experiencing the world.
Let me start by saying that the phenomena of the real physical world impact on my sensory equipment. I can’t directly experience the phenomena of light or sound, but light waves or sound waves can impact on my eyes or ears and they translate these signals into electrical phenomena sent to my brain where they are somehow turned into what I “perceive” as red, or yellow, or hissing, or screaming, or whatever. I use my brain to make sense of this information, to interpret it so that I can react or not react to it. This is how I interact with the world. It’s how I find food, drink, shelter, how I connect to other people, cope with the weather…..everything.

Tools of perception and understanding
To make sense of the signals and stimuli I use a couple of really clever tools – maps and stories.
I make maps in my mind of the objective physical world. Maps contain information organised spatially and temporarily. Maps represent the shared space of physical reality. Maps, as the NLP practitioners say, are not the territory. They say that because we tend to get confused and think that the way we perceive things IS the way things are but it is isn’t, it’s only how we perceive things to be and that perception is not static. It is malleable. We can work with it, alter it, become actively involved in creating it. We can change the way we see things, change our focus, change what we give prominence to, change the feelings we have in association with certain perceptions. So maps are a useful way for making sense of the world and for acting in the world.
If I want to eat I need a map of locations for food and I need to orientate myself on that map to see where I am and figure out how to go get food. We use all kinds of maps all the time. In fact, we perceive everything through these maps. It’s almost as if they are filters between the external reality and internal subjective experience. This is all pretty much an unconscious process. We don’t need to think about our maps or make any big deal about it, but we CAN make them more conscious.
Maps help us to organise the mass of information that bombards us continuously – sights, sounds, smells and so on – and they do this by helping us to selectively notice some elements more than others.
The maps we use are created by ourselves but often on the templates, or bases of given maps. If we live life fairly unconsciously, by that I mean without a high level of awareness (a zombie way), then we are probably negotiating the world on through a largely given set of maps. We do still make every map our own however by factoring in our past experiences, preferences, qualities and so on.
This is an interesting question. It means that there is a creative component to every map we use, but we live on some kind of spectrum of passive/active or receptive/creative (zombie/hero) kinds. If we increase our awareness then we have an opportunity to increase the extent to which we can actively create the maps we use to perceive the world. In other words, we can change the way we perceive the world instead of just accepting how its been either given to us by others or how we’ve created a view of the world for ourselves from past experiences.

The second amazing tool we use is storytelling.
Stories are our way of making sense of our experience. We tell ourselves and others stories that help us to know what something means, to help us explain to ourselves and to others what we are experiencing. In fact, we even use stories to create a sense of self – this is who I am, this is how I came to be here, this is where I am going. Stories are the way I convey my subjective inner reality to another, or try to understand the subjective inner reality of another. They are also the way I work to achieve a better understanding of shared space, of external physical reality. I do this by seeing how my understanding fits with another’s understanding.

So what if we consciously combine map-making/map-reading with storytelling and create “storymapping”? Starting with our physical reality, the space and time in which we live, collecting information from our experiences as we move through that space, and marking this information on maps in a way that we note what that information means to us, how we make sense of it, in other words, by telling the stories of our experience and tagging them onto the map of the physical space we have travelled through over that period of time.

Well, I thought, I’ll try this out with my daily morning walk to the train station on my way to work. I actually did it by printing out a map of Stirling from google but since then I’ve discovered that google maps now lets you easily tag a map and add text – just the tools I needed! Here’s my example.

I think we could make all sorts of storymaps. Here are some I’m thinking of exploring so far –

The idea is that different maps can help us to understand different aspects of ourselves. We use multiple maps in our minds all the time. We can make these physical maps as an exercise in self-awareness, self-understanding so we can give ourselves an opportunity to more actively shape our lives the way we want to.
Here are some of the possible maps I’ve come up with so far.

Map of relationships
You need to choose the scales of maps for this exercise and to focus on a particular period. The period could be the present time, or you could chart it in real time by recording relationships over a defined period – day, week, month.
I suggest using different colours of pencil for each type of relationship – relatives, work colleagues, friends/social contacts, (for me also – patients and students)
What I mean by type of relationship is what’s the main nature of the current interactions you have with this person? Sometimes a person may be on your map largely as a work colleague, other times they might be largely there as a friend.
Who to put on the map? It’s always up to you but I suggest just the people you feel you are actively interacting with – in other words, not all your cousins and aunts and uncles but only the relatives who are “active” in your experience over the period under consideration.
Geotag them – by this I mean place a tag or flag or spot or something representing them on the map where they are when you interact with them. Each geotag needs a number which we’ll use later.
There are a number of other complexities you can add to this map – size of tag relating to importance to you of this person, or size of tag relating to the amount of time you are spending in interaction with this person…..whatever you think might be useful
The reference numbers of each geotag will be expanded with text around the map which is where you’ll write the stories which describe these interactions or what they mean to you or how they affected you.

Food map
Three colours – blue for where you buy the food, yellow for where it is prepared, red for where it is consumed.
Start with the red – where you eat – add the yellow if you eat where the food was prepared and add the blue if this is also where the food was purchased – so all three colours together represent eating out somewhere. If you’re not eating out draw lines from the red spot to where the food was prepared and also where it was bought (where the yellow and blue spots will be) – over a period of time this will show you your pattern of food gathering and consumption. Each red spot should be geotagged and referenced to a short story describing the situation of the meal and what it meant to you

Sensory map
Record for a period of time (say a day) the sensations you notice. This will obviously not be ALL the possible sensations, just record the ones that strike you, the ones you feel are “notable”. Sensations are visual, auditory, olfactory, gustatory or kinesthetic. Note these as they occur to you using one of the following capture methods –
the video function of your cameraphone – making audio notes as you describe the sensation
the video function of a digital camera
write them on 3×5 index cards
write them into a pocket diary
Once you get to the end of the period of the exercise place the sensations on the relevant map geotagging them with index numbers to the storied descriptions/explanations.

Feelings map
As with the Sensory map but focussing instead on the feelings you notice

Attention map
As with the Sensory map but focussing instead on whatever catches your attention.

Activity map
As with the Sensory map but noting what you are doing over the period

What do you think? Any of these ideas appeal to you? If you do make any geostorymaps, please put the links into the comments to this post.

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Maps

There are two major ways in which we experience and understand our experience of the world. One of these is narrative and the other is mapping. We use narrative to make sense of our experience and to create a sense of self. We use maps to organise all the information that is constantly flooding our brains. All kinds of maps to situate ourselves in the world and to create some kind of order which allows us to navigate the spaces we live in. Maps are interesting though because they are not passive. When we lay a map on the world it focusses our attention and it predetermines our perception (you can’t see what you don’t know).

Here’s a map of the countries I’ve visited. This is from an interesting site which lets you tick, on a form, the countries you’ve visited, and it then automatically creates a map of the world with the countries you’ve visited coloured in, in red. I guess you could tell from this map that I live in Europe! Interestingly, the creator of this site has recently added another map “by popular demand” – the states in the USA which you have visited. Guess which country’s inhabits asked for that one?

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