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Archive for the ‘health’ Category

I’ve got lots of photos of spider webs. When there has been a heavy dew and the sun is just up in the morning they look absolutely bejewelled. Mesmerising and gorgeous. Most webs have that classic spiral appearance with a clear centre, and strands all spreading outwards from that centre, then concentric rings of web woven around and around that centre point.

But this one is different, and maybe you’ll look at it and think it’s not as beautiful because it has neither a clear centre, nor any lovely symmetries. But this structure is one of the most fundamental shapes in Nature.

It’s a network. It’s made up of two simple components – nodes and connections. There is no single clear centre, no branching or hierarchical structure. Some nodes are multiply connected, others only connected to two other nodes.

The cells and organs of our bodies are like this – they are multiply connected and once change takes place somewhere it spreads quickly through the entire network. There is no single commanding point. This is an incredibly flexible, adaptive structure and it is exactly what every “complex adaptive system” looks like – either literally, or functionally.

I find it utterly beautiful and wondrous. I love how I can understand human biology through this lens. I love how I can understand the brain through this lens. I love how I can understand ecosystems through this lens.

Every single one of us exists within, and emerges within, these vast complex webs or networks of Life. We don’t function like machines. The connections are not linear – instead they are “non-linear” – so effects can accelerate as they cascade through the system, and changes can occur which are utterly unpredictable from the starting state.

This reminds me of the importance of seeing each of us, not as separate disconnected individuals, but instead as unique instances of change within the entire web of Life.

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I’ve just finished reading Madeline Miller’s superb “Circe”. I can’t tell you just how much I enjoyed it. I found it a great read. I am a bit familiar with some of the Greek myths and legends, including the story of Odysseus, but this way of telling Circe’s story let’s Madeline Miller tell you some of those myths from a new perspective. I just loved it.

Last night I read a passage which made me think “Yes! I must share this!” Here it is –

When I was young, I overheard our palace surgeon. He said that the medicines he gave out were only for show. Most hurts heal by themselves, he said, if you give them time. It was the kind of secret I loved to discover, for it made me feel cynical and wise.

I have long believed exactly that. I used to say to patients something like “If you break a leg, the surgeon will apply a plaster to your leg to hold it still. The plaster doesn’t repair the fracture. It just holds the ends together while your body gets on with doing what it does – healing – or, in this case, repairing the fracture.” Or I’d tell someone “This antibiotic isn’t going to cure your bladder infection. What antibiotics do is to kill bugs. That’s a good thing. But your bladder wall is all inflamed because of the infection, and it’s that inflammation which is causing your symptoms. The antibiotic will have no direct effect on your inflammation. But it will reduce the number of harmful bugs in your bladder to allow your body to get on with doing what it does – healing.”

Does that seem unnecessarily pedantic? I don’t think so. I think it reinforces the patient’s belief that their body can self-heal – which is exactly what all “Complex Adaptive Systems” do – all living creatures have these abilities to self-regulate, self-defend, and self-repair. It’s what they do.

That’s the wisdom part.

But in Circe’s telling this knowledge also brings a certain cynicism, and for me, that’s always been about the place of drugs in health care. There isn’t a drug on the market which is designed to directly promote and/or stimulate self-healing and self-repair. Each drug attempts to redress an imbalance, or to suppress some symptoms or pathologies. The business of the body doing what the body does – self-healing and self-repair is left to be a hopeful sort of side-benefit at best.

There are ways to work more in harmony with the body’s natural powers, but, in my opinion, those ways aren’t taken seriously enough. Targeting pathology/disease and/or symptoms remains the dominant model. But I do dream of a time when the balance tips towards targeting health/healing and/or powers of self-repair, and self-healing. The present types of drugs and treatments will then be seen as the potentially useful adjuvants that they really can be. They will no longer be seen as enough by themselves.

Oh, by the way, “Circe” isn’t a book about health or disease. It’s a telling of some of the Greek myths. It’s just that passage really resonated with me so I thought I’d share it. And, on reflection, don’t those myths have something to tell us about disease and illness, and how we cope, heal and grow?

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I’m convinced the images we encounter daily influence what we feel, what we think and how we behave. In fact, I don’t just mean images such as artworks, adverts or photos. I mean how things look – including the shapes and sizes of buildings, the presence of trees, flowers and bushes, the colours of walls, the landscape or the cityscape, depending on where we live, and the decor, light and shapes of the rooms we live in, as well as the objects which surround us.

All of these images influence us deeply, and, largely unconsciously, creating moods, emotions and feelings which stimulate or inhibit well-being, and which change the course of our lives.

One dramatic example of that is in hospital design. There is a lot of research about this, but, to give one example, it was found that patients who had a view of nature from their hospital bed recovered more quickly, needed less painkillers, and had less complications than those who only had a view of a wall.

Of course the advertising industry is well aware of the power of the image. These days there is even a specialist area of knowledge and advised described as “neuro-marketing” which seeks to employ the findings from neuroscience to persuade customers to buy certain products. These things work at the level of image, sound and smell. Mostly, they work unconsciously.

So, I think it’s good to notice our here and now, our everyday reality. I think it’s good to be aware of the images we absorb as we work, play and relax in our home and shared environments.

Taking photos is a good way to become aware. When you look around, or go out somewhere with a conscious intention of photographing what you notice, then your awareness is automatically heightened. These days most of us have smartphones which are more than ably equipped to take photos. You don’t have to have a fancy camera.

These two photos I’m sharing today are of street art I noticed as I walked around the streets of Salamanca one day last year. The image on the left is like a work of modern art. It looks a bit “Miro” to me! What I really notice about it is how the artist has used the walled off entrance as a frame, using the concrete filling the space as a canvas, but, he or she hasn’t stopped there. They’ve spread their artwork beyond the bounds of that frame….reaching out to cover the left hand pillar. I like that. I like how it demonstrates how creativity can be opportunistic, inspired by what is already there (the walled-in entrance way), and how that inspiration can come from the most unlikely places. Would you have thought that entrance way represented a canvas? I like how the artist isn’t bound by that either. How they kept creating outside of the frame – thinking and creating “outside of the box”. This work inspires me to be creative, to see opportunities for creative work, and to refuse to be constrained by other people’s frames.

The second photo shows the power of stencil. I mean just look at this person holding their head. Are they in despair, or are they trying to figure something out? I can see both. So it’s an image of hopelessness which reflects something we all feel from time to time, but, instantly, it’s also an image of someone thinking, someone deep in thought, trying to come up with a solution. At least, that’s what I see there. How about you?

I know, with every interpretation we bring our own standpoint, our own sets of values and beliefs, our own moods and preoccupations. But that’s one of the great things about art, isn’t it? It isn’t just the power of the work to convey “percept and affect” (as Deleuze would say). It offers us the chance to wake up and change by engaging with it. And even if we don’t wake it, it influences us without us realising. It interacts with us, and we interact with it. It’s a relationship.

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Picking up on yesterday’s post about threads and weaving life stories, I thought I’d share this photo I took in an old weaving factory in Aubusson. Isn’t this a fabulous stock of yarns? Look at the colours!

Probably because I was thinking about the metaphor of threads and weaving in the way we create our reality through our stories, I looked at this image again today and thought “Well, that’s what they have to work with. That store of colours and shades” So what if we think about how that idea might apply to how we create our daily experiences?

What is there in your palette? What can you select to weave together to create your unique, singular experience of today?

What if these yarns are like beliefs, ideas, thoughts and emotions? Which ones do we have to draw on, and which do we keep going back to, perhaps over-using, when we could be shifting our attention and using a different section of the palette if we want today to be really different?

I remember reading about a theory, which seemed to be validated by studies and observations, that when a baby is born, at the moment when the umbilical cord is cut, they experience their first existential threat. In those first few seconds if the baby doesn’t take their first breath, they won’t live. Perhaps, in those few seconds, the baby experiences certain strong emotions. We don’t have access to those memories because in our early years, our consciousness and memory functions haven’t formed to allow us to access them, but that doesn’t mean to say they aren’t happening, all the same. After all, most emotions occur below the level of consciousness, and becoming aware of them takes time, attention and practice.

So, what emotions might a baby experience in the midst of this first existential crisis? The theory proposes three – fear, anger or separation anxiety. Makes sense to me. So, the idea is that maybe which of the three dominates is genetically determined, but, whether it is or not, that particular pattern of those three emotions sets itself up as a core as we continue through life and try to make sense of our experiences.

So, some people have fear at the core, and that’s the main colour they use in their daily palette. For others, it is anger, and for yet others it is separation anxiety. You can try this for yourself. See if you can think back to your very earliest memory. Preferably one form before the age of five, from before you started school. When you recall that event, what emotions do you associate with it? Is it fear, anger or separation anxiety? I found with patients that some would identify one of these very clearly, some would identify a mix, or find more than one strong early memory, each with a different dominant emotion. Others would find none. They either couldn’t access any early memories at all, or they wouldn’t be able to say which emotions they associated with any they could remember.

For people who can find one, it is interesting to then follow that thread through life. To what extent does that emotion seem a foundation to other significant life events? Remember that with each emotion, we might suppress it, express it, or deal with in some hybrid way. So, if it is fear, then both fear and courage might appear. If it’s anger, both temper and avoidance of conflict might appear. And so on…..

Well, that’s one way to start to think about what palette you have, and what section of the palette you draw upon most frequently to create your daily reality.

You can also become aware of your dominant emotions, thoughts and beliefs by journaling….for example by doing “morning pages”. In fact, there are many ways to become aware of our habitual patterns of emotion, thought and belief.

I think it’s good to explore this, but we can take it a stage further by deliberately choosing certain part of the palette, or even adding new sections. We can decide we want to colour each day with more joy, more wonder, more love. We can decide we want to see each day through more half full glasses than half empty ones. We can do that with affirmations, with visualisations, with making more conscious choices about where to focus our attention, our time and our energies.

But all that is maybe for another day. Today, I’m just suggesting an exercise in awareness. Can you become more aware of what your personal palette looks like? Can you become more aware of which sections of that palette you keep going back to again, and again, and again? Finally, which underused sections of your palette would you like to pay more attention to? Or as you look at the vast range available, which colours of yarn would you like to add now?

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I love stories. I always looked forward to hearing the stories patients would tell me, and I’m sure a significant part of my work was to be an active co-creator of stories. It would be common for a patient to sit down next to me for the first time, and I’d begin “Tell me your story”. Quite often that opening would be met with surprise or even some puzzlement, but I’d just stay quiet, maintain eye contact, and show I was waiting with undivided attention. Sometimes people would ask “Where will I start? How I am now, or what went wrong first?” I’d suggest there wasn’t a right or wrong place to start so just choose to start wherever they like.

The first part of the story would be up to the patient, but then I’d ask certain questions to explore particular aspects of the story, or to open up other areas which hadn’t been covered. So, together, we’d enable the telling of a unique story, a life story, with a certain focus – health and disease. Because, I am a doctor after all.

Now when I see this photo of threads beginning to be woven into a tapestry I think that rather than “focus” in that last paragraph, maybe I’d be better using the word “thread”. Because often the life story of health and disease is a story which needs unravelled, untangled, to identify the important threads, colours, textures, and images, or the important events, themes, experiences and patterns.

Maybe, in fact, the life story of health and disease is just one of the tapestries we create from all the threads and colours which allow us to create and experience our one, unique, and singular life.

So, threads, tapestries and images turn out to be as important for me as stories.

Where do the threads come from? The ones we weave into our personal experience? Some come from our genes. There are threads of lineage which run through each of us. Some come from our birth experience, and our response in those first few seconds to the cutting of the umbilical cord. Others come from our experiences, from the events of our lives and both our reactions and responses to those events. Yet others come from our relationships and from the physical environments in which we live.

Then there are other kinds of threads which we pick up and make our own. The threads of myths and legends. The threads of other peoples’ stories, beliefs and values. The threads of culture, music and art. In other words, the threads of our collective imagination.

Finally, as well as threads, the weaver has to have some idea of what they want to create. They have to have a vision, have imagination, maybe even have a pattern or a plan to follow.

I wonder what threads you can find in your life. I wonder what visions, thought patterns, feeling patterns, behaviours and influences create what you do with those threads…..

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How much do you think love motivates you to do what you do, to say what you say, to think what you think?

Are there serious arguments against making love our priority, our touchstone, our foundation, our core?

What couldn’t be improved by bringing a loving attitude to bear?

I think good health care requires love….love in the form of caring about, caring for, and wanting the best for, every patient. Love in the form of non-judgemental listening and attending. Love in the form of respect for the unique individual. Love which values personal relationships above techniques, tools and processes.

I think good education requires love…..love for children, love for knowledge, love for wisdom, love for growth, development and maturity. Actually, education isn’t something we should restrict to children, we could all do with learning all our lives. We could all benefit from life long education based on loving each person and wanting to try to help them realise their potentials.

I think good work requires love….love for craft, for skill, for quality, for service to our fellow workers, our families and our communities.

So how about a politics of love and an economics of love ….. love of Nature, of Planet Earth, of our fellow creatures, and of other people? What would that look like?

Maybe it’s time for us to be less shy about love. Maybe it’s time for us to speak up and say it’s important. More than important….essential.

Can we learn from this pandemic and move towards a society based more on creativity and care, than the present model which is based on consumption and competition? Can we move towards a society based more on qualities than on quantities, challenging the current dominance of figures, statistics and “data”, and insisting instead on loving, caring relationships, on experiences, on individual uniqueness, and on diversity?

I’d like to see that. How about you?

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This is a machine. It is manufactured by human beings. It has a number of solid, pretty unchanging parts (ok, they all gradually wear out with use), which are assembled into fixed relationships with each other by other parts…. nuts, bolts, springs, cogs and hinges.

These parts don’t grow. They don’t develop or mature. They don’t develop new ways of connecting to each other and they don’t change their function. Their relationships are linear. A always leads to B.

This machine looks a bit complicated but everything can be taken to pieces and understood. We can learn how it works and predict how it is going to work. It does what it was designed to do and if it stops doing that we can find the parts which are “defective” and replace them with new parts.

Living creatures are not like this. Human beings are not like this. We are not manufactured by human beings. Every cell, every tissue, every organ within the body changes all the time. The massive network of inter-connected feedback loops create relationships in the human body between cells, tissues and organs. These relationships are non-linear. A influences B in the presence C, D, and a host of others, whilst B, in turn influences A. These relationships are not fixed. They are not predictable.

Living creatures, like human beings, are “Complex” not “Complicated”. You can’t take them to pieces and understand the whole.

We are all “complex adaptive systems”, constantly bathed in flows of molecules, energies and information, which we transform within ourselves before contributing to their onward flow into others.

Machines can exist in isolation. Human beings cannot. We live only because we are embedded in the complex biosphere of Nature, dependent on the lives of a myriad of other forms of life, dependent on our relationships with others.

Machines are not unique. You can produce millions of identical machines. Human beings are unique. There has never been “YOU” before in the whole history of the universe, and there will never by “YOU” again, once you die.

The truth is every one of us is special, and every one of us deserves to be treated as unique. Every one of us deserves to be understood within our individual web of connections, relationships and life story.

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It strikes me there is a paradox at the heart of what it is to be human. We each have a sense of being different from other people. We experience what Freud termed “the ego”. It’s a sense of “self”, of a kind of centre of the universe from which we observe and interact with everyone and everything else. Our immune system is finely tuned to quickly recognise anything that is “not me”, to identify it as a potential threat and to mount inflammatory and/or allergic responses to contain and/or expel it. We need to know that we matter, that we have value and worth, and whilst some of that comes self-referentially as “self-belief” and “self-worth”, a lot of it comes from that other, somewhat paradoxical theme – the fact that we are social creatures.

We need to belong. Complete isolation is a punishment – we call it “solitary confinement”. We need to find common ground with others, to be accepted by a family, a group, or a community. We need to find and express what connects us to others so that we can share our experiences with them.

This paradox of separateness and belonging is never “resolved” if we see them both as opposite, unconnected poles. Although they are undoubtedly difficult to reconcile, they need to be “integrated” – in other words we need to find how we can connect them to each other in ways which will enhance and develop both.

It’s important to grow and mature as an individual. It’s important to feel free, to have personal autonomy. It’s also important to grow as communities, as a species, (if we want to evolve), and even as an integral part of all Life on Planet Earth. We share the same air, the same water, the same limited “resources”. We create waste which cannot be contained. What I do affects others. There’s no getting away from that.

If an individual takes a strong exclusive position on one of these two needs, they lose their necessary connection to the other one. That results on the one hand in selfishness and narcissism, and on the other, as auto-pilot, group-thinking, which sets them up for domination and manipulation by others.

These things make us sick. They set in train the forces of dis-ease.

To be healthy and fully human we need self-belief and self-knowledge. We need freedom and autonomy. We need to belong, to form loving, caring and mutually beneficial relationships. We need to find common ground with others. And we need to see ourselves as inseparable individuals emerging from, and embedded within, the whole – the whole species, the whole living planet, the whole universe.

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Reflecting – I’ve long since thought this is a vital tool in life. There are two main modes of being – reactive and responsive. When some information, some energy or a substance evokes something within us our default is to react.

For example, when we see something threatening our “fight or flight” system kicks in fast and prepares us to do one of those two things…..fight or flee! It’s a complex system involving nerve pathways like the “autonomic nervous system”, certain nodes within the brain, like the “amygdala”, and a release of chemicals such as adrenaline and cortisol. Accompanying all that are the organising influences of the emotions. It happens fast.

The energy of heat makes us react too. When we get too hot our body re-routes the blood flow towards the surface of our skin, and we start to sweat, to try to maintain a steady body temperature in the face of the environmental change. There are many such reactive feedback systems in our bodies to enable us to react to environmental changes. All without requiring any conscious, active role, ourselves.

When we inhale an allergen, such as pollen, then, if we have the potential to be “allergic” to it, we react instantly with sneezing, runny nose, itchy eyes, or whatever, all provoked by an automatic activation of part of our defence system.

All of these are reactions.

But we humans can also respond. We don’t need to be 100% on auto-pilot. We respond, rather than react, by creating what the psychiatrist and author, Iain McGilchrist refers to as “the necessary distance”. We have this remarkable super-power to create a pause, a bardo, or a gap, between the stimulus and the response. We can stand back, stand apart, and change our perspective. This gives us our chance to reflect and it is a major factor in enabling us to move beyond an auto-pilot way of living.

Meditation practices of all types help us to step out of auto-pilot mode too. They strengthen our ability to become more aware in the present moment, and so open up the opportunity for us to play a more active role in our own lives. But reflection, I think, brings an additional benefit.

If a major benefit of meditation is heightened awareness and a breaking of the automatic stimulus-reaction loops, then reflection allows us to bring both our analytic functions of reasoning and our ability to imagine to bear. We can look back, unpick and unpack an experience and use the benefit of hindsight. We can “figure out” what happened and why and choose to act differently on any similar future occasion. We can think through a series of “what if”s to become aware of different potential outcomes.

As a doctor, I was encouraged to do this all the time. It is a common practice for doctors to reflect on their clinical work. That’s how we learn. That’s how we improve. But it’s the same in all walks of life. Stopping regularly to reflect frees us up – you could say it turns us from “zombies” into “heroes” (hero in the narrative sense – the main character of our own story).

There are many ways to build habits of reflection into your everyday. I think the top three are “Morning Pages” – where you write continuously to fill three pages of a notebook, preferably before you do anything else in the day; “Gratitude Journals” – where you end the day by thinking back and noting anything today for which you feel grateful; “Journaling” – whether in diary form, sketching, painting, whatever you prefer, but some regular time spent reflecting and then turning that reflection into something creative – a short essay, a poem, a letter to an imaginary friend, a letter to your older, or younger self, a cartoon, a drawing…..it’s up to you.

Oh, I should add, that it’s essential that all reflection is as non-judgemental as possible. It’s not about beating yourself up, or finding people to blame. It’s about learning and growing and a judgemental attitude isn’t going to help that.

What works best for you? How do you encourage yourself to reflect?

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What protects us from infection?

The immune system.

What supports, encourages and maintains a healthy immune system?

The answer is lots of things, and no one thing by itself. There isn’t a magic pill or single technique which will keep your immune system healthy, but I thought it might be worthwhile just summarising some of the things which have a good chance of helping.

Nature

My first one is Nature. Japanese scientists have shown that “forest bathing” boosts immune activity. It seems that trees actually send out certain chemical which boost particular immune defence chemicals in the human body. But there’s probably a holistic, experiential element active as well. In other words, it’s probably not all down to particular molecules in the atmosphere. Because we also know that just spending time in natural environments boosts health….to the extent that Richard Louv describes Nature as “Vitamin N” and hypothesises that most of us are suffering from “NDD” – “Nature Deficit Disorder”. It seems that whether we are in a forest, in a garden, up in the hills, walking along the sea shore….all of these places are probably positive for our health and our natural defences.

Physical activity

There seems to be ample evidence that physical activity and many forms of exercise can both boost positive moods, and reduce unhealthy levels of inflammation which damage the immune defences. The bottom line is the more inactive your are, the worst it is for your whole system. Physical activity can include walking, jogging, gardening, sports, swimming, cycling – there’s a wide enough range there for pretty much everyone to find some kind of physical activity they can enjoy.

Diet

There are gazillions of articles about so-called healthy diets, or “anti-inflammatory” diets, or whatever. It’s mind-bogglingly confusing! But I think there are certain well established themes which run through every single “healthy diet”. It starts with eating mainly plants. Diets high in fruit and veg turn up again and again in research which identifies what seems to help to reduce chronic diseases, boost immune defences, and even encourage longevity. The second part is minimising what damages us – and that comes down to refined sugars and artificial chemicals more than anything else. How do you do that? Well, most simply by eating what is prepared by hand at home. The more processed, the more industrialised the “food” we eat, the more we are exposed to the harms. Ideally the more you can eat locally produced, seasonal foods, the better. And the more you can eat food from farms which don’t use artificial chemicals or industrialised techniques, the better. But the bottom line is “the less processed the better”. The third part is not eating too much – of anything! Whether you do that through an “intermittent fasting” diet, or simply by stopping snacking between meals, limiting consumption to what we need is good for us.

Supplements

I’m not a fan of supplements. Probably because I’m one of those weird people who finds it nearly impossible to swallow capsules and most pills! I also think we evolved to get what we need from Nature. However, again and again we are finding that Vitamin D deficiency makes us vulnerable. I’ve read a number of studies showing that vitamin D deficiency is most prevalent in patients who get the most severe forms of COVID. But vitamin D deficiency has been implicated in a host of chronic illnesses. So I do recommend it.

Other supplements? I’m pretty convinced about the value of two others when it comes to viral immune defence – Vitamin C and Zinc.

So, that’s what I take, and that’s what I’ve recommended my whole family takes. Vitamin D (4000 iu), Vitamin C (1G) and Zinc (15mg) every day just now. But you should find out for yourself, because we are all different sizes and ages and the amounts to take vary. So, be clear, I’m not prescribing these supplements for you….do your own research and ask health care professionals who trust, and, especially, ask your doctor if you are already taking medication. Immune defence is certainly not all down to supplements but they are worth some consideration.

Stress

There are undoubted, unavoidable links between the immune system, the nervous system and the endocrine system. Stress and emotional distress undermine the body’s defences. How you manage stress, and what practices work best for you, will differ from person to person, but it’s likely to involve some form of mental practice such as Meditation, Cognitive Behavioural Therapy, Heartmath, Visualisation, keeping a Gratitude Diary, or something like that. That’s in addition to spending time in Nature and taking exercise, both of which also reduce stress.

Maybe you already know what you can do to reduce stress, it’s just you find it hard to set aside the time to do it. Well, now is the time! Start today!

Emotional intelligence – there’s a link between stress and emotional intelligence – by that, I mean that learning to handle our emotions lowers stress, and that stress makes emotional turmoil worse. This is way too big a subject to tackle in a single blog post but I thoroughly recommend learning about your emotions, and how to handle them.

Love

I’ve left this one to last because I guess it’s the least “scientific” factor, but whether it’s longevity studies or studies of well-being, again and again human relationships are shown to be important. We need to be engaged, we need to love and to feel loved. We need that in relation to other people, to other creatures, to Nature, to Life. And that’s pretty tough in times when were are forced into social distancing, or even worse, social isolation. That’s why it’s so important for societies to make sure that whilst physical distancing might reduce the chances of spreading the virus, people are not isolated. We need contact, communication, simple checking in to see if we are ok, or if we need any particular help. We need to know that we are valuable, appreciated, even loved. Without that we are likely to suffer from more stress and less effective defences.

I am sure there’s a lot more you could add to this subject, but my bottom line is that I think we don’t pay enough attention to consciously, actively improving our well-being and our immune defences. If there was ever a time to do that, it must be now.

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