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Archive for May, 2019

I think it’s pretty well established that being out in Nature is good for us – good for our physical and our mental health – but also good for well-being and just feeling that life is worth living.

I know that since I moved from a second floor flat in Central Scotland to a house with a garden in the Charente that I’ve been out in nature much more, that I feel closer to nature, more a part of nature even – that I feel more in tune with the birds, the seasons, the plants, the rhythms of Life and this World.

I think it’s also pretty well established that one of the aspects of being human which distinguishes us from other creatures is Art. The philosopher, Giles Deleuze said there are three ways of thinking – philosophy, which is thinking about concepts; science, which is thinking about function; and art, which is thinking about percepts and affects. I’ve always found that model useful. I enjoy all three ways! In terms of visual art I do enjoy galleries, but there’s something especially impressive I find when I come across art in Nature.

Here are some examples from a recent trip I made up to the Loire Valley –

What about you?

Have you any favourite examples of art in natural settings to share?

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One of the most striking characteristics of any natural environment is diversity.

Diversity of species, diversity of colour, of form and size.

If you think two plants are identical, you’re not looking well enough.

Every single living organism is born into, matures in, and dies in, a unique time and space, a unique environment in which it experiences an life which has never been lived before, and which will never be repeated in its details.

You might find that hard to swallow when you are thinking about flowers, but I bet you don’t find it so difficult when you think about yourself, your parents, your siblings, your children, your friends and colleagues. Do you?

And yet, we live in societies which seem determined to flatten out, or ignore our differences. We are reduced to averages, to mere examples of a “mass”, to statistics. Yet in the lives we are actually living we don’t find these so-called averages. Nobody quite fits that mould. We are not elements of a mass, but unique creatures living together. Life can’t be reduced to what can be measured, to mere statistics. We lose something essentially human when fail to see what’s unique.

It seems there’s another power at work too – conformity. The social, economic and physical pressures to be the same…to consume the same products, to produce the same products, to have the same desires, wishes and opinions. There’s a terrible reductionism in the world, the worst of which are the binary ones – the ones which reduce life to “either/or” to “us/them” to “good/bad” to “citizens/foreigners”….you can find your own ones all around you, dividing the world into two groups on the basis of race, gender, belief, sexuality, nationality.

When I get overwhelmed by the stories of “the rise of the populists”, of xenophobia, prejudice and cruelty, I find it re-balancing to walk slowly in the plant world and remind myself how reality is based on uniqueness, how Life thrives on diversity. Then to bring those principles and values back into my everyday life.

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I’m having one of those synchronicity weeks. This one is about time. I stumbled across this old photo the other day. I took it in Salon de Provence. It was at the top of a tower in the middle of the town. I don’t think I’ve ever seen a clock like this before. Instead of dividing the day into hours and minutes, it divides the week into seven days. And it uses the ancient astrological/mythological origins of the names of each day – starting at the top, where the arrow is pointing, is Jupiter, for “Jeudi”, or Thursday (in English we swapped Jupiter for Thor, but both carry a thunderbolt), next in sequence is Venus (Vendredi, or in English, Friday, again swapping the Greek goddess and planet for Frigga, the Germanic goddess of married love), then Saturn, for Saturday, the Sun, for Sunday, the Moon for “Lundi” (or Monday), Mars for “Mardi”, (again, the English swapped Mars for the German god of war, Tiw) and Mercury for “Mercredi” (yep, you guessed it, the English went to the Germanic gods again, and swapped out Mercury for Woden).

Apart from the powerful use of the ancient symbols for the days of the week, what impressed me about this clock was its single hand, which slowly and smoothly moved from day to day. That felt immediately like a different pace of life.

This week I listened to the BBC’s Start the Week podcast about “Bergson and Time“, possibly the best, and clearest introduction to Bergson’s startling concepts of time I’ve ever heard. I recommend it. Bergson, in essence, talked about two kinds of time – lived time, the time we actually experience, (which he called “duration”); and measured time, which is artificial and divides the flow of time into discrete pieces we call hours, minutes and seconds.

I’m reading Jacques Ellul’s “The Technological Society” at the moment, and just this afternoon read this –

At most, life had been regulated since the fifth century by church bells; but this regulation really followed a psychological and biological tempo. The time man guided himself by corresponded to nature’s time; it was material and concrete. It became abstract (probably toward the end of the fourteenth century) when it was divided into hours, minutes and seconds. ….The first private clocks appeared in the sixteenth century. Thenceforward, time was an abstract measure separated from the traditional rhythms of life and nature. It became a mere quantity.

and

Today the human being is dissociated from the essence of life; instead of living time, he is split up and parcelled out by it.

Then, today, in Austin Kleon’s weekly newsletter he has a link to a post, “Working with time” –

“Like, you can always make more. I think that’s why I’m a time-based worker. I try to go at my work like a banker. I just have hours. I show up to the office and whatever gets done gets done. “And I’ve always been a time-based worker. You know, like, ‘did I sit here for 3 hours and try?’ I don’t have a word count when I sit down to write. It’s all about sitting down and trying to make something happen in that time period — and letting those hours stack up.

Now, there are writers who work in quite the opposite way, sitting down to write a certain number of words or pages each day and just doing that until it is done, irrespective of the hours passed. I’m not claiming one way is better than the other, just that it’s interesting to become aware of the difference between lived time and measured time.

And to wonder about how the influences our everyday lives. (this second photo is one I took in the Musée d’Orsay, in Paris)

Are we distanced from the rhythms of Nature, of the World, by the machinery of time-pieces?

That’s Ellul’s claim, and I think we are. Whilst machines often allow us to achieve what we couldn’t have without them, I think it’s healthy to step out from that occasionally and re-connect ourselves to Natural Time…..re-connect ourselves to Nature. Get a dose of Vitamin N.

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I was in Bayonne recently, and stopped to read this plaque (I was going to say “notice” but it isn’t a notice, it’s words chiselled into stone so that they don’t fade. It’s a “plaque”)

I read it as – “Here was the tower where people deposited abandoned infants. It disappeared in 1867”.

OK, so I don’t know Bayonne, and I didn’t know the history behind these words, but they chilled me. I was already standing still because I’d stopped to read them, but I felt my breath stop, my heart quicken and some tears come to my eyes. Yes, real, physical changes in my body provoked by reading some words.

That kind of thing happens all the time, so why do we insist on talking about the body and the mind as if they are two separate, isolated, if related, parts of a person? Isn’t it obvious that we change as whole organisms? Without any duality of the so called physical and the so called invisible?

Immediately after reading it I looked at the bars on this little window and felt quite confused. Isn’t a “tour” a tower? So where was the tower? But that turned out to a be a misunderstanding on my part. There are many possible translations of the word “tour” from French into English. This plaque doesn’t refer to a tower at all. It refers to this actual window. It was a kind of hatch which the abandoned children were passed through. The “tour” here refers to a “tiroir tournant”, a kind of drawer which turned around. A baby, sometimes accompanied by a few words on a scrap of paper, was placed in the drawer, which was then turned around so that the baby was now on the inside. The inside was a hospital, Le Maison Dagourette, and this device in the wall was the same as one found in Florence, in the wall of the “Hospital of the Innocents”.

Isn’t this just so sad? And yet, in one way of thinking, there’s nothing sad here at all. What was sad is long since gone. So why did it “infect” me like this? Why did I experience a surge of sadness? I suppose it was the story in the form of these brief words, the physical reality of standing on the spot where the story came from, and my imagination……

So, there’s something else this little experience did for me. It reminded me how the past is always here, in the present. It doesn’t go away. We can be moved by it in the here and now.

 

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Take a look at these two photos.

The first one is of an office block I saw in Malmo, and the second is of a leaf in one of the glasshouses in The Royal Botanic Gardens, Edinburgh.

No, seriously, just pause for a moment and look at both of them.

What similarities do you see, and what distinct differences?

The extremely regular, beautifully straight lines of the office block are very striking to me. It’s an image full of right angles and, what shall I say, hard edges. I find I’m both attracted to it, and repelled by it. There’s a beauty there in the symmetries, the reflections and the colours, but you’ll see I included that little street sign in the bottom left corner to convey what I really felt – let me out of here! There’s something limiting, bordering, imprisoning even about those hard lines. It immediately makes me think of conformity, regularity, 9 – 5 work…….it definitely induces, in me, a desire to escape!

This leaf is really strange. I don’t think I’ve seen one just like this before. That’s the first thing to grab me. It’s uniqueness. I’m sure the office block is unique too, but maybe mainly because of its location, its situation. This leaf immediately stirs my curiosity. It draws me towards it. I want to look closer. And when I do I see what at first glance were a multitude of totally regular small lines turns out to be not regular at all. The spaces between those little bars is varying all the time. They are not like a printed bar code (as I thought at first when I saw it) but display an irregularity, a diversity, a constantly changing variation.

This issue of regularity/irregularity reminds me of something I learned as a doctor. You know the image of a cardio trace? I’m sure you’ve seen it on screens in medical dramas, even if you’ve never seen one in real life. Here’s an example –

Well, each of those peaks is a heart beat and if the heart was beating very regularly then the distance between each peak would be exactly the same. Except it isn’t, not exactly. If the time gap between each heart beat is identical that’s a sign of a heart that’s about to fail. What’s healthy is when there is something called “heart beat variability” – not something totally chaotic, but subtle little differences in time between each of the beats. That’s partly because as you breathe in, you increase the pressure in your chest, and as you breathe out, you decrease it. The heart has to respond to that. And it’s partly because when you stand up, your heart has to pump the blood a little faster and harder to keep the flow to your brain, and when you lie down, the opposite happens…..and we’re changing our positions all the time. So if the heart is unable to respond to all those changes it will just keep beating entirely regularly….and then it might not cope.

Just so you don’t get worried, let me just emphasise that too much irregularity is a bad thing for both the heart and your health! There are many “arrhythmias” (irregularities) which require to be treated. I’m talking here about the healthy heart which beats with a healthy variability. The “Heartmath” method is based on this understanding.

Here’s the next thing I thought about when I realised that the pattern in the leaf showed constant variation – wabi sabi. You know about wabi sabi? It’s a Japanese concept, a little difficult to explain, which includes seeing the beauty in “irregularity” – according to this view, something too regular, too hard edged and fixed, isn’t so beautiful. Partly because Nature shows us the beauty of variations and irregularities everywhere we look.

 

 

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Sometimes (quite often, actually) I find a particular subject or issue crops up from extremely diverse sources in the same day. Does that happen to you? I suppose Jung called it “synchronicity” but the first time I really thought about the phenomenon was a teenager when I read Arthur Koestler’s “Roots of Coincidence”  which explored this phenomenon from a rather paranormal perspective. 

I don’t know how these things happen, but they just do! 

Today it was the term “Homo Economicus” – not a term I was particularly aware of, though I was aware of elements of the neoliberal economic paradigm of “rational actors” and the centrality of “self-interest”. This morning I stumbled across it in a  podcast – the “Pitchfork Economics” podcast which I just subscribed to. Well, their latest episode is entitled “Homo Economicus must die”. 

 

I listened to it in the car while I was out and about and really enjoyed it. They interviewed an economist called Samuel Bowes and I thought he was both clear and convincing. 

Then when I came home I checked my Twitter feed and there was a tweet referencing the “Boston Review” It was headed “Inclusive economics is Complexity economics”. 

 

It was the reference to “complexity” which got me clicking through, because that’s a subject I’ve been interested in for many, many years. Well, the linked article quickly got onto discussing, yes, you guessed it, “Homo Economicus”.

Nick Hanauer, in the podcast, says –

Yeah. So Homo Economicus, just to remind everybody is a simplifying assumption that neo-classical economists make, about what humans are and how they behave. Basically it assumes that people are perfectly selfish, and perfectly rational, and that we are utility maximization machines, that we have consistent preferences, that we have no biases, or the biases are randomly distributed. We use probabilistic reasoning. That we are frame and context-independent. That we can do things like exponential discounting, and that we have infinite cognitive abilities, we have time and infinite willpower, and information and attention are broadly distributed.

Now here’s the thing is that we now know that with scientific certainty, that none of those things are true….

 

and he goes on –

the last 40 years of behavioral, psychological and sociological research shows unambiguously that people are not Homo Economicus, that we are actually Homo Sapiens and that we are other-regarding, reciprocal, approximating, heuristic, emotional and moral.

There follows a funny bit about how Spock and Captain Kirk might shop in a supermarket, then they bring in Samuel Bowes. He says the “Homo economicus” model arose from the reasonable belief that when we see people acting we can assume their actions are purposeful, then goes on to describe how people think and what they are thinking about. 

It assumes people think logically, and rationally, weighing up the probabilities of the utility value of various possible outcomes to each action. Except we don’t. Not all the time. In fact, maybe hardly ever. Instead we think, what he terms, “viscerally” – emotionally. This is behaviour which is instinctive and doesn’t involve looking forward into potential futures. 

Secondly, it assumes that what people think about is themselves. That self-interest is the basis of all our choices and behaviours. 

He explains why neither of these assumptions are true, and how the ability to act co-operatively and socially is now thought to give evolutionary advantages over acting selfishly. 

these ideas of incentivizing everything by essentially harnessing self-interest, they don’t work very [00:18:00] well and they certainly cannot address the basic problem facing humanity today. We cannot design incentives which would be good enough so that the environment will be saved for entirely selfish people who don’t care about future generations. There’s no way to design a kind of what’s called an economics, a mechanism that will do that.

These guys are arguing that prosperity doesn’t come from selfishness. It comes from acting on the basis of mutual interest. 

In the Boston Review piece, the authors state – 

Homo sapiens looks almost nothing like Homo economicus. Instead of asocial, transactional, self-regarding utility maximizers, real humans are intensely social, highly cooperative, and other-regarding creatures who make decisions inductively, heuristically, mimetically, and through group reasoning. Evolution has wired us to be both selfish and groupish. It has given us a repertoire of biochemical, neurological, emotional, and behavioral tools to help us successfully navigate life in groups and to help groups compete against other groups. These tools range from hormonal responses that trigger caring instincts, to neural capacities that vicariously experience the welfare of others, to behavioral strategies for reciprocity, cooperation, and punishment of those who violate group norms. These emotions and behaviors have in turn co-evolved with cultural norms, including our moral norms.

Instead of the neoliberal model based on self-interested rationalists, they argue that economics, and, hence, social and political policy, would be better based on an understanding of complex systems. This would allow us to acknowledge the importance of values such as fairness and reciprocity, to work with the natural diversity and heterogeneity of human populations, instead of flattening them all out into averages, and to deal with the world’s problems at a systems level which will take a multidisciplinary approach instead of a narrow, specialised one. 

Now maybe you’re not that interested in economics, or even politics, but I think both are aspects of human life that none of us can avoid. The “Homo Economicus” model seems bonkers to me from the start. It just doesn’t reflect reality. Maybe it’s time to get behind the challenges to the beliefs that we should encourage self-interest, selfishness and greed if we really want to deal with the problems we are all facing together. Maybe it’s going to turn out that empathy, compassion, co-operation and collaboration will be better tools to use.

Oh, before I go…..I liked how this discussion acknowledges that we are all BOTH selfish and altruistic, that we are BOTH rational and visceral. It reminded me of how we have two such different cerebral hemispheres with such different ways of engaging with the world, and how we have to use BOTH of them to be fully human. The Homo Economicus model seems straight out of the left hemisphere.

Isn’t it time to activate the other half of the brain? The half that looks for connections, and prioritises relationships?

 

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I read an article in the Washington Post about a  book entitled “Compassionomics: The Revolutionary Scientific Evidence That Caring Makes a Difference,” by Stephen Trzeciak and Anthony Mazzarelli. Well, there’s a new word – “compassionomics”! I guess they are picking up on all the other “-nomics” people are describing these days to highlight networks of influence. The key point of the book is that in hundreds of studies looking at a huge diversity of outcomes, it seems having a doctor who is compassionate produces better results.

They cite things like

Research shows that the odds of patients having optimal blood-sugar control is 80 percent higher, even after controlling for age, socioeconomic status and gender. It also shows 41 percent lower odds of serious complications from diabetes.

and

Studies show that warm, supportive interactions from either doctors or nurses right before going in for surgery resulted in patients being more calm (with better achievement of adequate sedation) at the start of surgery and a decrease in the need for opiate medication following surgery. Patients also spent less time in the hospital.

They say you can figure out if the doctor is compassionate if they have the following behaviours –

  • Sitting (versus standing) while speaking with you.
  • Facing you and making eye contact.
  • Caring about your emotional and psychological well-being.

And they shouldn’t interrupt you (remember that 2018 study from the Mayo Clinic which showed doctors first interruption occurs at 11 seconds into the patient’s description of their main problem?)

Patients who receive compassionate care recover more quickly from the symptom that brought them to the doctor, have fewer visits, tests and referrals. The proportion of these patients who are referred to specialists is 59 percent lower, and diagnostic testing is 84 percent lower.

And, to counter the belief that you might be best with a doctor who just has the best skills, irrespective of whether or not he or she is compassionate, they cite studies which showed “de-personalised” surgeons (the most distant ones) committed the greatest number of surgical errors.

Hey, who would have known? Giving a damn means you practice more carefully!

Now, I’m in two minds about this whole thing. I mean, I definitely believe that doctors should be compassionate. In fact, I think if you are a doctor or a nurse and you don’t care about the patients, you are in the wrong job. Compassion, for me, is THE core skill of any health care professional. Yes, yes, of course you want a doctor with good knowledge and good skills. That’s important too. But compassion is of fundamental importance. The whole philosophy behind these studies is utilitarian. It’s about producing “better outcomes”. That’s the bit I’m in two minds about. I’m not a die hard utilitarian but I do want patients to experience good “outcomes”. I guess I just think there’s more to it than that….I think the very experience of being cared for, being listened to attentively and non-judgementally….is a Good in its own right. I’d want that whatever the utilitarians could show….

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Some years back I went for a walk in the woods and was surprised to find these two trees kissing. Stumbling across the photo again today reminded me of the words of the Italian physicist, Carlo Rovelli –

The world is not a collection of things, it is a collection of events. The difference between things and events is that things persist in time, events have a limited duration. A stone is a prototypical ‘thing’: we can ask ourselves where it will be tomorrow. The world is made up of networks of kisses, not stones.

“the world is made up a networks of kisses, not stones”……..isn’t that lovely? Of course, stones only appear as “things” because they change so slowly. Every one of them came about through a sequence of events too. The “limited duration” he refers to is the timescale of a human life, mostly. There was a time when every single “thing” we see didn’t exist, and there will come a time when it ceases to exist. But in the meantime, and here’s the even more important point, I think, every “thing” is constantly changing. Maybe kisses don’t last long, but their effects can ripple out through our lives for years…..generations even!

Actually, I think there’s an even more important point than the fact that absolutely everything constantly changes…..it’s that reality is a network of relationships. Each of us is a mind-bogglingly complex network of cells and molecules, constantly interacting with each other. And each of us lives in a multitude of environments, physical, psychological, social, cultural, and so on….which means we are constantly exchanging molecules, energies and information with the rest of the universe.

There is nothing I can do, say or even think, which isn’t going to send out ripples through these networks and environments and there is nothing in those environments which can be walled off to prevent them from setting off actions and reactions too.

I think that’s why we should do our best to be loving, kind and understanding, rather than judgemental, angry and hating. The former creates, stimulates and grows, the latter poisons and destroys.

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I was reading an interview with Harvard historian, Anne Harrington, who has written “Mind Fixers: Psychiatry’s Troubled Search for the Biology of Mental Illness”.

When I was at university I was taught there were two types of depression – reactive and endogenous – the former occurring in response to specific events, and the latter seen as an illness of internal origin. It was thought that talking therapies, as they’ve come to be called, were the best way of dealing with reactive depression but that endogenous was a biological problem which required drugs. One of the main themes which emerged from that thinking was the serotonin theory of depression which was the basis for the great commercial success of Prozac, a drug which influenced the levels of serotonin in the brain.

Well, it all changed. Psychiatrists stopped distinguishing between “reactive” and “endogenous” and moved to thinking of all depression as biological and, hence, all requiring treatment with drugs.

But that didn’t last. As Anne Harrington describes, in the late 90s, “a range of of different studies increasingly seemed to suggest that these antidepressants – although they’re helping a lot of people – when compared to placebo versions of themselves, don’t seem to do much better.” As the “gold standard” of drug effect is its performance over that of placebo, and drug after drug was shown not to be that much better, it got harder and harder to bring new drugs onto the market. She says –

“But it doesn’t mean that the drugs don’t work. It just means that the placebo effect is really strong. But the logic of clinical trials is that the placebo effect is nothing, and you have to be able to better than nothing. But of course if the placebo effect isn’t just nothing, then maybe you need to rethink what it means to test a drug”

This is the same observation as Irving Kirsch made in his “Emperor’s New Drugs”. In that book he drew a graph which I found very impressive –

 

 

The point he was at pains to make was the same as Anne Harrington’s – well, actually, he was trying to emphasise that just because the drugs didn’t seem much more effective than placebo didn’t mean that doctors should stop prescribing them. But the main point, I think, is –

Placebo is not nothing

It seems crazy to me that people make decisions about whether or not a treatment should be offered to patients solely on the basis of its statistical difference to placebo if those decisions then lead to the withdrawal of treatments which were helping thousands of patients.

If the placebo effect is not the same as doing nothing (and it is clear that it is NOT the equivalent of doing nothing) then we should be exploring just what it is. That will involve moving on from the stigma of trickery, because that’s how the placebo effect has been portrayed. “Dummy pills”, “inactive pills”, “mock treatments” producing real life changes in the patients who receive them, only to reveal to them that, ha! ha! you got nothing!

I think it’s interesting that it is in the area of psychiatry that this debate has emerged. Because we know something of the power of placebo on our mental states. But as we are whole, body/mind, non-dual beings. What influences our mental states, influences our bodily functions too. Placebo effects are not restricted to changes in mental states, they are seen throughout the body, influencing organs, cells and circulating levels of natural chemicals.

Here’s the other thing – if placebo is NOT the same as doing nothing but a drug doesn’t show a substantial and significant benefit over placebo, then what else can we offer the patient? What else will be at least as powerful as placebo, but less harmful than the drug?

What about exercise, nutrition, the creation of significant social relationships, engagement with natural environments, meditation, learning how to handle our emotions for starters? And not forgetting demanding that we do something about the conditions in which more and more chronic illnesses are emerging – both mental and physical – poverty, poor housing, inequality, polluted environments, industrial, chemical methods of agriculture and food production and so on – have a look at the perspective I described in “There still aren’t enough”, and in “Inequality and health”.

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