I spotted this the other day……a discarded cigarette packet lying on the wall of a cemetery…..makes you think……so, did this…..
at the station the smokers throw their fag ends onto the end of the line…..just beyond the buffers. Wonder if they actually hit the buffers??
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There are many interesting studies of the placebo effect which show the potential of a “chemically inert” substance to produce biochemical and physiological changes in a human being, ranging from the release of endorphins to the loss of hair in chemotherapy trials in volunteers given a placebo which they believe might be a chemotherapy drug. One of the most startling I remember reading was where medical students were given either a barbiturate or amphetamine. The former of these drugs is a sedative, and the latter a stimulant. The researchers switched the labels basically – they told the students who were given a barbiturate that it was an amphetamine and those who received the amphetamine were told it was a barbiturate. Amazingly the students experienced the effects of the drug they thought they were receiving even though they were swallowing the drug which should have done the opposite.
Here’s a more recent study which is just as startling. This shows that people taking part in a trial of painkillers experienced pain severity dependent on their expectation.
The volunteers were placed in an MRI scanner and heat applied to the leg at a level where it begins to hurt — set so that each individual rated the pain at 70 on a scale of 1 to 100. An intravenous line for administration of a potent opioid drug for pain relief was also introduced. After an initial control run, unknown to the participants, the team started giving the drug to see what effects there would be in the absence of any knowledge or expectation of treatment. The average initial pain rating of 66 went down to 55. The volunteers were then told that the drug would start being administered, although no change was actually made and they continued receiving the opioid at the same dose. The average pain ratings dropped further to 39. Finally, the volunteers were led to believe the drug had been stopped and cautioned that there may be a possible increase in pain. Again, the drug was still being administered in the same way with no change. Their pain intensity increased to 64. That is, the pain was as great as in the absence of any pain relief at the beginning of the experiment.
The MRI showed brain changes consistent with their reported experience of pain. In other words, despite receiving a powerful painkilling drug, when they were told the active drug wasn’t there, their pain increased – counteracting the “effects” of the drug.
This is yet one more study which shows that the placebo effect is a real effect – it’s not pretend, it’s not about just believing you feel better, it’s not the same as taking nothing. However, what really stimulated my interest in this study was this final quote in the report –
‘We should control for the effect of people’s expectations on the results of any clinical trial. At the very least we should make sure we minimize any negative expectations to make sure we’re not masking true efficacy in a trial drug.’
The “true efficacy”? What’s that then? The effect of the drug with the human taken out? The effect of the drug disregarding the subjective reality of the patient? What world is that? Is that the world you live in? Are there any humans who have no subjective reality? No values or beliefs? No inner experience? And isn’t pain, and pain relief, in fact, a subjective, inner experience? The “true efficacy” of a drug includes the placebo effect. The “true efficacy” of a drug is, in part, dependent on what the prescriber says and does. The “true efficacy” of a drug is the real experience of real human beings.
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March is named after Mars, the God of War, although, actually you could argue, that he was a symbol of military power for peace. I thought this was a good opportunity to focus on strength and assertiveness for the month.
I find that people commonly have disorders of the boundaries, or their defences. When it’s hard to say “no” then it’s hard to have the self-care you need in order to respond to the desires or needs of others. Learning to say “no” appropriately requires assertiveness (not the same thing at all as selfishness or the pursuit of self-interest). When we find it hard to be assertive, our boundaries are weakened and we can either become overwhelmed, or our defences can go “hyper” to our disadvantage, driving everything from irritability with others, to auto-immune reactions. It’s really not uncommon to find this is an issue in a patient with an autoimmune disorder.
By strength, in addition to assertiveness, I also mean the ability to stick at things, to be both consistent and persistent. It’s not so much a matter of trying to have power over others, or trying to control life, but more a matter of resilience, resolve and stamina.
So, why not take the opportunity to reflect on that this month? How do you feel about your own personal strength? Not your power over others, but your autonomy, your resolve, and your staying power……
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Our willingness to listen to music is a biological trait and related to the neurobiological pathways affecting social affiliation and communication, suggests a recent Finnish study.
The understanding of the “biology” and even evolutionary position of music in human life is something I hadn’t really thought about until I read Ian McGilchrist’s excellent, “The Master and His Emissary“. In that work he describes the theory that music was the precursor to language and that one of its unique functions was to develop and strengthen bonds between people in a group, and to communicate at a “feeling” level, rather than at a more cognitive one.
The particular issue of the relationship between music and bonding is explored in the way the right hemisphere functions, and how it has a major role in the appreciation of music, and in the forming of social bonds. This Finnish study refers to some very similar ideas.
Similarities between human and animal song have been detected: both contain a message, an intention that reflects innate emotional state that is interpreted correctly even among different species. In fact, several behavioral features in listening to music are closely related to attachment: lullabies are sung to infants to increase their attachment to a parent, and singing or playing music together is based on teamwork and may add group cohesion.
Rather less interesting (in my opinion) is their exploration of the genetic “associations” (although I was pleased to see this word “associations” rather than “determinants”) related to the appreciation of music.
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You know that thing that happens where a noise stops and it’s only when it stops that you realise just what a noise it was? Well, I had a similar experience yesterday and today. When I went out for a walk yesterday this is what I saw –
No, I don’t mean Stirling Castle, I see that every day. I mean the blue sky! Look at it! Not a cloud in sight! Then as I walked to the railway station this morning it was so light I couldn’t believe it. I began to wonder if I’d slept in, or if the clocks had changed and I’d missed it. It feels like we’ve gone from weeks and weeks of winter darkness, just suddenly into Spring sunshine….
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Another great post from Seth Godin
Great innovations, powerful interactions and real art are often produced by someone in a state of wonder. Looking around with stars in your eyes and amazement at the tools that are available to you can inspire generosity and creativity and connection. Anger, on the other hand, merely makes us smaller.
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Once you learn that most of the activity of the brain goes on without either conscious awareness, or with conscious awareness only kicking after the initial response, you begin to doubt that all our choices are conscious ones…..or rational ones. In fact, the brain stem and the limbic system are the key centres for our survival responses, our drives, our avoidances, and our emotional processing. How often do we behave in ways which really can’t be understood from the premise of consciously choosing once presented with the facts? Is that how human beings function? Would that even be the best way for human beings to function? (consciously and rationally, whilst discarding other ways of perceiving, processing our experience and responding). What do you think once you learn that there is an enormous neural network around the hollow organs of the body, the heart, and the gut especially, which we might well use to figure things out….where we might process and produce what we call “gut reactions”, or “heart felt” beliefs?
I’ve stumbled on two very different texts in this area in the last couple of days. Isn’t that weird, actually? It’s that old “coincidence” thing again…..never quite got to a point of really figuring out how those “coincidences” come about, or what they mean.
A few days ago, I read about a report for the WWF called “common cause“. The report, written by Tom Crompton. Essentially it argues that if we look at the research evidence, it would seem that human beings don’t make decisions using rational thought very much. Here’s a paragraph from the Summary –
There is mounting evidence from a range of studies in cognitive science that the dominant ‘Enlightenment model’ of human decision-making is extremely incomplete. According to this model we imagine ourselves, when faced with a decision, to be capable of dispassionately assessing the facts, foreseeing probable outcomes of different responses, and then selecting and pursuing an optimal course of action. As a result, many approaches to campaigning on bigger-than-self problems still adhere to the conviction that ‘if only people really knew’ the true nature or full scale of the problems which we confront, then they would be galvanised into demanding more proportionate action in response. But this understanding of how people reach decisions is very incomplete. There is mounting evidence that facts play only a partial role in shaping people’s judgment. Emotion is often far more important [see Section 1.3]. It is increasingly apparent that our collective decisions are based importantly upon a set of factors that often lie beyond conscious awareness, and which are informed in important part by emotion – in particular, dominant cultural values, which are tied to emotion. It seems that individuals are often predisposed to reject information when accepting it would challenge their identity and values.
That’s got me thinking about the importance of understanding our values (and/or our “virtues”) again.
Then, this morning, I read a post about some interesting TED videos, and the first one was this, by Dan Airley. He makes the case that we suffer from “cognitive illusions” just as much, if not more than, we suffer from “optical illusions”. (It’s about how we make decisions. It’s VERY entertaining, and thought provoking, and it’s just 17 minutes long. Take the time to watch it)
Posted in from the living room, from the reading room, from the viewing room, life, neuroscience, perception, psychology | 1 Comment »
Have you read the book, “The Butterfly and the The Diving Bell”? Or seen the movie? If so, you’ll have an idea of what “locked in syndrome” is. It’s where someone is completely paralysed and unable to communicate apart from maybe being able to blink an eye. Can you imagine? Can you imagine what that must feel like? Well, read this study of people who have this condition and prepare to be amazed. 91 people took part in this study.
Over half the respondents acknowledged severe restrictions on their ability to reintegrate back into the community and lead a normal life. Only one in five were able to partake in everyday activities they considered important. Nevertheless, most (72%) said they were happy.
Said they were happy! Isn’t that amazing? And here’s what amazes me, perhaps even more.
But a shorter period in the syndrome — under a year — feeling anxious, and not recovering speech were also associated with unhappiness. A greater focus on rehabilitation and more aggressive treatment of anxiety could therefore make a big difference, say the authors, who emphasise that it can take these patients a year or more to adapt to this huge change in their circumstances.
In other words, they adapted. Doesn’t this speak volumes about the human capacity to adapt? And doesn’t it make you wonder just what happiness is?
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I was going to title this post “And not or”, but then I realised that very title was falling into the trap which “or” always poses – it divides. The General Semanticists talk about “two value thinking”. Others say this tendency to categorise into two categories is “digital” thinking, in the sense of “on” or “off”, “1” or “0”. Of course we are often faced with such simple choices in life – “go left” or “go right”, “stay home” or “go out” and so on. The drawback of “or” comes when one of the choices is rated as “right” and the other as “wrong”. When that happens, the digital choice is reduced to only one option – the RIGHT one, or as Mrs Thatcher famously said, “There is no alternative”. We see this in health care in the dangerous distortion of “evidence based medicine” to create a digital rating system – treatments “which work” and those “which don’t”, which is then extrapolated to those treatments which should be made available and those which should be withdrawn. In so many instances this is a delusion. Most drugs don’t do what they’re “proven” to do for most of the people who take them.
So, what’s the alternative?
“And”
This insight has emerged from the internet, but applies to everything which could be considered using networks as a conceptual framework. On the net, you don’t have to think, will I publish my work on “Flickr” of “Blipfoto“? Will I “tweet” or post on “facebook“? Will I blog, or will I “stumble“, or will I “posterise“? You can do them all, link them all, and communicate much more widely than I could if I had to choose only one, and discard the other options.
But “and” has another great power. Instead of considering a reduced set of information, say, for example, from using “the scientific method”, we can also consider the perspectives brought from subjective experience, from cultural mores, from both individual and group perspectives and so on.
Think of Deleuze’s three ways of thinking – science – thinking about function; philosophy – thinking about concepts; art – thinking about percepts and affects.
Think of Wilber’s “Integral Theory” with it’s elegant four quadrants.
Think of the benefits of truly multidisciplinary working where all the disciplines bring relevant insights.
I much prefer “and” to “or”, and I rarely believe Mrs Thatcher’s “There is no Alternative”. Alternatives are always there. We just need to open our eyes to see them.
Here are two songs about “and” and “or” – I love them BOTH.
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It seems strange to me that so much of “health care” is focused on diseases and their management. A disease is always only a part of a patient’s life and experience. Whilst it’s important to deal with disease when it’s present, surely that’s never enough. Health is experienced by a person, a whole person, and care is expressed in relationships. Without a focus on health and care, what kind of “health care” do we get?
At times it seemed to her they were so focused on disease that patients and suffering were incidental to their work
Cutting For Stone. Abraham Verghese
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