Blog Explanation

This blog brings together content that is noticeable, important or otherwise interesting from a human givens point of view.

Tuesday, 6 December 2011

Dreaming Takes the Sting out of Painful Memories, Research Shows

ScienceDaily (Nov. 23, 2011) — They say time heals all wounds, and new research from the University of California, Berkeley, indicates that time spent in dream sleep can help us overcome painful ordeals.
UC Berkeley researchers have found that during the dream phase of sleep, also known as REM sleep, our stress chemistry shuts down and the brain processes emotional experiences and takes the edge off difficult memories.
The findings offer a compelling explanation for why people with post-traumatic stress disorder (PTSD), such as war veterans, have a hard time recovering from distressing experiences and suffer reoccurring nightmares. They also offer clues into why we dream.
"The dream stage of sleep, based on its unique neurochemical composition, provides us with a form of overnight therapy, a soothing balm that removes the sharp edges from the prior day's emotional experiences," said Matthew Walker, associate professor of psychology and neuroscience at UC Berkeley and senior author of the study to be published on Nov. 23, in the journal Current Biology.
For people with PTSD, Walker said, this overnight therapy may not be working effectively, so when a "flashback is triggered by, say, a car backfiring, they relive the whole visceral experience once again because the emotion has not been properly stripped away from the memory during sleep."
The results offer some of the first insights into the emotional function of Rapid Eye Movement (REM) sleep, which typically takes up 20 percent of a healthy human's sleeping hours. Previous brain studies indicate that sleep patterns are disrupted in people with mood disorders such as PTSD and depression.
While humans spend one-third of their lives sleeping, there is no scientific consensus on the function of sleep. However, Walker and his research team have unlocked many of these mysteries linking sleep to learning, memory and mood regulation. The latest study shows the importance of the REM dream state.
"During REM sleep, memories are being reactivated, put in perspective and connected and integrated, but in a state where stress neurochemicals are beneficially suppressed," said Els van der Helm, a doctoral student in psychology at UC Berkeley and lead author of the study.
Thirty-five healthy young adults participated in the study. They were divided into two groups, each of whose members viewed 150 emotional images, twice and 12 hours apart, while an MRI scanner measured their brain activity.
Half of the participants viewed the images in the morning and again in the evening, staying awake between the two viewings. The remaining half viewed the images in the evening and again the next morning after a full night of sleep.
Those who slept in between image viewings reported a significant decrease in their emotional reaction to the images. In addition, MRI scans showed a dramatic reduction in reactivity in the amygdala, a part of the brain that processes emotions, allowing the brain's "rational" prefrontal cortex to regain control of the participants' emotional reactions.
In addition, the researchers recorded the electrical brain activity of the participants while they slept, using electroencephalograms. They found that during REM dream sleep, certain electrical activity patterns decreased, showing that reduced levels of stress neurochemicals in the brain soothed emotional reactions to the previous day's experiences.
"We know that during REM sleep there is a sharp decrease in levels of norepinephrine, a brain chemical associated with stress," Walker said. "By reprocessing previous emotional experiences in this neuro-chemically safe environment of low norepinephrine during REM sleep, we wake up the next day, and those experiences have been softened in their emotional strength. We feel better about them, we feel we can cope."
Walker said he was tipped off to the possible beneficial effects of REM sleep on PTSD patients when a physician at a U.S. Department of Veterans Affairs hospital in the Seattle area told him of a blood pressure drug that was inadvertently preventing reoccurring nightmares in PTSD patients.
It turns out that the generic blood pressure drug had a side effect of suppressing norepinephrine in the brain, thereby creating a more stress-free brain during REM, reducing nightmares and promoting a better quality of sleep. This suggested a link between PTSD and REM sleep, Walker said.
"This study can help explain the mysteries of why these medications help some PTSD patients and their symptoms as well as their sleep," Walker said. "It may also unlock new treatment avenues regarding sleep and mental illness."
Other co-authors of the study are UC Berkeley sleep researchers Justin Yao, Shubir Dutt, Vikram Rao and Jared Saletin.

Therapy in the Air Focused attention on breathing can boost mood By Tori Rodriguez | Scientific American Mind and Brain, November 29, 2011

Feeling tense? Paying attention to your breathing for a few minutes could soothe your nerves. Practicing such mindful breathing regularly may even lead to better mental health, according to two recent studies.
In an experiment reported in May in the International Journal of Psychophysiology, researchers at Toho University School of Medicine in Japan taught healthy subjects to breathe deeply into their abdomen. After subjects maintained attention on breathing this way for 20 minutes, they had fewer negative feelings, more of the mood-boosting neurotransmitter serotonin in their blood, and more oxygenated hemoglobin in the prefrontal cortex, an area associated with attention and high-level processing.
Another study, in the April issue of Cognitive Therapy and Research, looked at depression symptoms. Investigators at Ruhr University Bochum in Germany asked healthy participants to stay in mindful contact with their breathing—maintaining continual awareness without letting their mind wander. During the 18-minute trials researchers asked the subjects frequently whether they were succeeding in doing so. Those who were able to sustain mindful contact with their breathing reported less negative thinking, less rumination and fewer of the other symptoms of depression.
“In my opinion, the cultivation of mindfulness through breathing meditation helps to prevent depression,” says study author Jan M. Burg, although he cautions that this interpretation goes beyond the findings of his research. Mindfulness, Burg explains, may allow people to disengage from dysfunctional rumination, a central risk factor for depression.
Anyone can try a bit of this technique on the fly. Simply sit up comfortably and breathe naturally. Focus your attention on your breath, feeling it in detail—in the nasal cavity, the chest and the abdomen. If you notice your mind wandering, try to redirect your attention to your breathing—it is important, Burg says, not to criticize yourself during this process. At first it might be difficult to stay focused, but with some practice you should be able to hit the mark these studies showed to be beneficial, about 20 minutes. And once you have the hang of it, even a few minutes of mindful breathing can help you become more calm and collected before a high-stakes meeting or any other stressful situation.

Friday, 18 November 2011

A Harvard psychologist is developing evidence-based treatments for the devout By Sarah Estes Graham and Jesse Graham | Tuesday, October 25, 2011 | 89

This year has been the worst in recent history for natural disasters in the U.S., with record-level floods, fires, and hurricanes. Such disasters naturally bring up questions about why, and religious beliefs are often part of the answers given. Fred Phelps of Westboro Baptist Church claimed that the tornado in Joplin, MO was a direct result of the town’s sins. Michele Bachmann’s aides scrambled to classify her comments about Hurricane Irene’s “message to Washington” as a joke. With each new tragedy comes a familiar chorus on the retaliatory nature of an avenging God, or the seeming vengeance of a loving God trying to save us from ourselves. Either version depicts the central attachment figure of Judeo-Christian culture as shaky and capricious, and this view can have real-life implications for believers.
A recent Gallup Poll showed that the number of Americans with no religious affiliation has jumped from 9 percent to 16 percent over the last decade, but the overwhelming majority self-identify as religious. Presumably, some of the unaffiliated group still maintain core spiritual beliefs as well. In a culture where over 80 percent of the population identifies itself as Christian (37 percent of those evangelical), people’s beliefs about the nature of the divine can have significant ramifications on mental health—particularly in times of great uncertainty.
Yet, despite its critical role in mental health, there has been a kind of “church and state” separation regarding spirituality in clinical theory and practice. For instance, Aaron Beck’s cognitive theory, and the cognitive behavioral therapy it inspired, is among the most empirically validated models in clinical psychology, aiding scientific understandings of anxiety, depression, and even schizophrenia. Core beliefs about the self, world and future are its principle province, yet little has been done to address the role of patients’ spiritual beliefs in this foundational system.
A recent study led by Harvard Medical School’s David Rosmarin was undertaken to close this gap between the sacred and the profane in clinical practice. Studying hundreds of devoutly religious Jews and Christians, the researchers explored what religious cognitions can lead to more or less worry. Specifically, they found that mistrust in God (measured by agreement with statements like “God is unkind to me for no reason”) was associated with nearly clinical levels of worry, while trust in God (measured by agreement with statements like “God is compassionate toward human suffering”) was associated with less worry. Interestingly, trust and mistrust in God were not just opposite ends of one attitudinal dimension; it’s possible for believers to have high levels of both simultaneously.
Across two studies – one of which measured changes in worry and religious cognitions over a two-week intervention period – the researchers also found that the effects of trust and mistrust in God on worry took place via the mechanism of tolerance of uncertainty. Mistrust in God led to less tolerance of uncertainty (e.g., feeling upset when stuck with ambiguous information), which in turn led to increased levels of worry. Increasing trust in God, however, led to more tolerance of uncertainty, decreasing levels of worry.
Besides the applied benefits of reducing anxiety in devoutly religious samples, the findings are notable in that they are among the first to integrate explicitly spiritual beliefs into psychological models of mental illness and anxiety. The authors urge the need for further “assessments of spiritual/religious factors in clinical work and their integration into evidence-based treatments,” and one can see why: Clinical practice often lags behind critical research-based findings on what actually works, and this can be particularly true in religious communities.
In fact, tensions between the secular and sacred counseling realms are so powerful that many parishioners are advised against seeking treatment, or seeking treatment “in house” via pastoral counseling with a clergy member, for example, or discussions with a scriptural study group. A number of mainstream denominations have stances ranging from vague resistance to outright antagonism towards psychology, often fearing secular interference, psychological reductionism, therapy-initiated narcissism, and even a profane preoccupation with worldly success.
It’s not clear yet whether future scientific considerations of religious factors in clinical symptoms will allay such fears among religious people, or make them worse. Clinical interventions aimed at increasing trust in God (and decreasing mistrust in God) could be seen as a refreshing attentiveness to the concerns of religious people, or could be seen as an attempt to “fix” crucial existential and theological questions. The “dark night of the soul” (Why did this happen? Why are my prayers going unanswered? Why all this suffering and injustice?) is, after all, seen as a necessary part of the life of the spirit in many religious traditions. In other words, the treatments would seem particularly beneficial for people questioning their religious traditions, or treading the murky waters of excessive religious guilt and shame within a tradition – but it’s doubtful that Phelps is going to be referring his parishioners to therapy any time soon.

Exploring the science of emotional residues By Daisy Grewal | Tuesday, November 1, 2011 | 18

Imagine that your co-worker has just moved into a new office. The woman who used to work there spent many unhappy months in the office complaining about her job. In fact, she ended up quitting in a fit of rage. Upon moving into the office, your co-worker tells you that she senses some “bad energy” leftover from the previous employee. Would you believe her? Or would you think she’s a tad crazy?
Or imagine instead that you’re choosing between two apartments. They are identical with one exception: you happen to know that the former tenant in one of the apartments was an extremely happy, joyful person. Would you be more inclined to choose that apartment, based on an expectation that you might experience some lingering good feelings?
Your answers reflect how much you believe in “emotional residue,” which is the idea that emotions can hang around a physical environment, long after their owners have left. New research suggests that at a gut level, most of us believe that emotional residue exists. However, the culture we’ve grown up in determines the extent to which we consciously and openly endorse those beliefs.
Krishna Savani of Columbia University, along with his colleagues, ran several identical studies using both American and Indian participants. In an initial study, he asked participants whether it’s possible for emotions to travel outside of the human body. Many of the Indian participants agreed with this possibility, while most Americans disagreed with it. However, when Savani measured people’s beliefs in more subtle ways, he found that both Americans and Indians seem to believe strongly in emotional residue.
He had participants from both countries read scenarios about David, a college freshman who moves into a new dorm room. The previous student who lived in the room was described as having spent a lot of time there feeling either very happy or depressed. Savani asked his participants to predict how David would feel a couple of weeks after living in his new room. Both Indians and Americans predicted that David would feel similarly to the student who had lived there before. In other words, he’d feel happy if the previous student had been happy and sad if the previous student had been sad.
Using a different scenario, Savani looked at people’s beliefs about how emotional residue influences other people’s behavior. He had participants read about Margaret who sublets an apartment from a woman named Alice. Unbeknownst to Margaret, Alice spent the last couple of months in the apartment feeling very sad, due to problems she was having with her boyfriend. Margaret moves into the empty apartment and immediately begins feeling very happy. Savani asked his participants, “To what extent do you think Margaret’s behavior is surprising?” Both Americans and Indians said they found Margaret’s behavior surprising. They expected her to feel sad after moving into a space that had witnessed so much recent sadness.
In a final study, Savani looked at whether beliefs in emotional residue influence people’s actual behavior. He ran an experiment where he gave people a choice of two different rooms in which to fill out a survey. The sign on the door of one room indicated that the previous occupants had spent the past two hours recalling happy life events. The sign on the other door indicated that the previous occupants had spent the last couple of hours remembering unhappy life events. He then made note of which room the participants chose to enter. Savani found that the majority of both Americans and Indians chose to fill out their surveys in the room where they thought people had previously spent time recalling happy memories.
To find out whether people chose the room simply because it was associated with more positive feelings, Savani also examined his participants’ beliefs in emotional residue. He discovered that people who were more likely to believe in emotional residue were also more likely to choose the room with the happy sign. Therefore, beliefs in emotional residue, and not general positivity, seemed to be driving his results.
In India, people often burn incense to clear out emotional residue. Americans may engage in similar rituals in their attempts to get rid of “bad energy.” Such rituals could include anything from keeping windows open, to saying prayers, to aromatherapy. An article published in the New York Times earlier this year profiled a feng shui expert who, for a fee, helps new apartment dwellers clear out the negative energy accumulated by previous tenants.
Beliefs in emotional residue have some interesting implications for behavior. For example, might people be willing to pay less for a home or office after being told that the previous occupants experienced a lot of negative emotions there? Might someone choose a less beautiful home over a more beautiful one, if the less beautiful house was thought to have less emotional residue? The answer to these questions may depend on how long people believe that emotional residue tends to hang around.
The question of whether emotional residue actually exists remains to be answered, but intriguing new research suggests that it may have biological underpinnings. A well-publicized study from earlier this year demonstrated that human tears emit a chemical that other people detect and respond to. Specifically, women’s tears were shown to reduce testosterone and sexual arousal in men. Research by Wen Zhou and Denise Chen of Rice University have demonstrated that human sweat glands emit distinct chemicals when people experience different emotions. In addition, they showed evidence that other people can sense those chemicals at a later point in time. Taken together, these new findings suggest that our intuitive beliefs in emotional residue may be more than just superstition.
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Friday, 11 November 2011

Feeling Safe and Secure? CUMC scientists find it’s all in the caudoputamen From Bio-Medicine News

New York, NY April 18, 2005 Scientists at Columbia University Medical Center have made a surprising finding about positive emotions that should change the way people think about anxiety disorders.

The researchers Michael Rogan and Nobel laureate Eric Kandel discovered that a previously unknown "safety circuit" exists deep within the brain and is responsible for the good feelings associated with safety and security. The findings appear in the April 21 issue of Neuron.
"This work points to a second system in addition to the brain's well-known fear circuits that probably malfunctions in some people with anxiety disorders," says the study's first author, Michael Rogan, Ph.D., of Columbia's Center for Neurobiology and Behavior. "This opens up hope for other types of treatment that can act on your sense of safety and security."
The new safety circuit may also lead to a better understanding of addiction since the circuit operates in the same part of the brain known to be involved in addiction. "There's a feeling of invulnerability that comes with alcohol and other drugs," Dr. Rogan says. "Addicts frequently say, 'I had my first drink, and I felt safe for the first time,' so it may be that drugs of abuse artificially activate some aspect of this safety mechanism."
Anxiety disorders previously linked only to fear
Most anxiety research focuses on the brain's fear circuits and it's easy to understand why. Fear, after all, is the problem in anxiety disorders. "When someone goes to a psychiatrist in terror or grinding anxiety, the doctor doesn't think about the patient's happiness issues," Dr. Rogan says.
Yet the neurobiology of happiness, which has generally been ignored by researchers as well as physicians, may be equally important in the disorders. "The missing part of our picture of anxiety is the good feelings associated with being safe and secure," Dr. Rogan says. "But positive emotions are harder to study in the lab than negative emotions like fear. How do you know when you've made a mouse feel safe and secure?"
The experiments described in the Neuron paper do exactly that. Michael Rogan trained mice to recognize that they were safe from danger (mild electrical shocks) when they heard a particular sound. He then recorded what happened in the mice brains before and after they heard the safety sound.
As expected, in accordance with previous theories, information about the safety sound traveled through the brain's fear circuits and reduced the amount of activity in the brain's fear center, the amygdala.
"Researchers have generally talked about safety in terms of a reduction of fear, and it's no surprise that we found that the safety sound reduces neural activity in the amygdala," Michael Rogan says.
But Rogan and Kandel also found that the safety signal traveled through other, previously unknown circuits that lead to the brain's caudoputamen, a region known to be involved in motivation and reward. This region became more active when the mice felt safe and secure.
"Our results show there's more to the feeling of safety and security than the simple absence of danger," Michael Rogan says. "We have found that there is another part of the brain that is involved in calculating how much protection or shelter is in the environment. Shelter is something that is independent of the presence or absence of danger, and it contributes to a sense of well being."
The next step, Rogan says, is to verify that the same safety circuits are present in people. He is now planning a brain imaging study that will look for activity in the caudoputamen of people conditioned to link a sound with safe conditions in the midst of aversive events (in this case, a blood-curdling human scream, not electrical shock).
Eric Kandel, the senior author of the paper, is University Professor and Kavli Professor at the Center for Neurobiology and Behavior at Columbia University, and a Senior Investigator at the Howard Hughes Medical Institute.
Contact: Craig LeMoult,, 212-305-0820, Columbia University Medical Center, 20-Apr-2005'"/>

Stress, control and Status Syndrome – Michael Marmot

The Life Scientific, Radio 4, 1.11.11

When Professor Sir Michael Marmot was a junior doctor he decided that medicine was failed prevention.
To really understand disease you have to look at the society people live in. His major scientific discovery came from following the health of British civil servants over many years. The Whitehall studies, as they're known, challenged the myth about executive stress and instead revealed that, far from being 'tough at the top', it was in fact much tougher for those lower down the pecking order. This wasn't just a matter of rich or poor, or even social class. What Marmot showed was the lower your status at work, the shorter your lifespan. Mortality rates were three times higher for those at the bottom than for those at the top. The unpleasant truth is that your boss will live longer than you.
What's more, this social gradient of health, or what he calls Status Syndrome, isn't confined to civil servants or to the UK but is a global phenomenon. In conversation with Jim Al-Khalili Michael Marmot reveals what inspires and motivates his work.
Extracts from interview conducted by Jim Al-Khalili (JK)with Michael Marmot (MM)

MM: Definition of epidemiology: The study of disease and the distribution of disease in populations and the determinants of that distribution. Now applied to non-communicable disease, to mental illness, to accidents.  

JK: And is it [epidemiology] something that can tell us more about the individual.

MM: Well, a lot and a limited amount. By that I mean we know that if you eat a certain kind of diet, everybody who eats that diet, on average, is likely to be healthy compared to those who don’t. It doesn’t necessarily tell each individual the determinants – the reason why you’re healthy and someone else isn’t might be because you are genetically different; but in general it says quite a lot about the conditions affecting your risk of illness.

JK: So coming back to the Whitehall Study, what did looking at the grades of civil servants tell you?

MM: To my amazement and to the amazement of everybody I showed these data to, and initially disbelief, we found the lower the status, the higher the risk of heart disease. But it wasn’t just mortality from heart disease it was mortality from a whole range of diseases. So that the lower the status, the shorter the length of life. So in a study without the richest and without the poorest we showed the lower you were in the hierarchy the higher the chance of dying of heart disease – step by step down the gradient. So the top level civil servants had the lowest risk of dying from heart attacks; the next level down somewhat higher, the next level down higher still – it was a social gradient from top to bottom.

JK: And that’s what’s so surprising, because you would think that anyone above a certain salary level should have a similar life expectancy and levels of disease. So the idea that this kept on changing continuously all the way to the top was quite revolutionary.

MM: It was, if you like, revolutionary, certainly very challenging to understand. So then we had to think, well if it’s not poverty, it’s something to do with your status. What is it about your status that can have this profound [impact] – it’s not subtle, it’s life and death – it’s having a profound impact on people’s health?

JK: There’s something else going on.

MM: And that’s why I set up the Whitehall 2 study.

JK: So Whitehall 1 – you found there was this smooth gradient going all the way from the bottom to the top of the Civil Service structure. Whitehall 2 – what did you find?

MM: What I think Whitehall 1 led me towards was that what goes on in the mind is very important for what goes on the rest of the body. So we talk about psychosocial processes, how social influences affect the mind and how that in turn affects other parts of the body to change the risk of disease. We studied the work environment, the idea that it’s not having a lot of demand by itself that is stressful. The high status person has a lot of demand, but he or she has a lot of control, and the combination of high demand and low control is what’s stressful. And then the idea was that would influence various biological pathways that would increase risk of cardio-vascular disease. And indeed, the data are imperfect, but we’ve got a lot of evidence supporting that.

JK: Michael, can you give me an idea of how the social gradient affects life spans of individuals?

MM: In the Scottish city of Glasgow, men in the poorest part of the Glasgow have life expectancy of 54; and in the richest part of Glasgow, 82.

JK: It’s incredible…

MM: Isn’t it incredible?

JK: So when we’re looking at the causes of stress, you’re saying it’s a combination of not being in control and having high demands on you. I’m thinking of a simple example here where I could try and prove the contrary. Imagine in a school the person manning the reception desk who just answers the phone won’t have much control, but that’s a pretty low-stress job when you compare it say with the head-teacher’s job where you have the control but presumably there’s lots of demands and lots of stress therefore on your time. Does that fit into your model?
MM: Yes, by and large it does. We distinguish between passive jobs, where there’s low demand and low control, and jobs where there’s high demand and high control, which in general in my own view, are the best ones. But I’m willing to predict that the times when head-teachers feel most subject to stress is when they think they’re subject to some higher authority [e.g. when] the government’s fiddling with their lives. In other words they’re losing the control that normally they have. Now the kind of job that you might think is a low-stress job but in fact isn’t, is when people tell you, “We weren’t allowed to talk to each other. We had to ask permission to go to the toilet or to get a cup of coffee.”

JK: They’re not in control…

MM: You’re not in control of even simple things…this is ghastly, the idea that your life is controlled to that degree.

JK: So they may not have the responsibility of someone higher up the structure of the organisation, but the fact that they have no control is far more stressful.

MM: And we showed that people with low control at work in the face of high demands and lack of support from supervisors and co-workers had higher risk of the so-called metabolic syndrome, which is a precursor to diabetes and a risk marker for heart disease. So we showed that the more occasions people had this stressful pattern of high demand, low control and low support, the more likely they are to have the metabolic syndrome, which is a precursor to diabetes and heart disease.

JK: Now this is what you call “Status Syndrome”. The extent to which you define someone’s status and therefore their life expectancy is very specific. There’s a study that says that someone with a PhD will live longer than someone with a Masters degree. Can you really say that someone with a PhD has more control than someone with a Masters degree?

MM: Well, Robert Erikson who did that study in Sweden, he said that it’s very interesting that in general the people with Masters or professional degrees had higher income than the people with PhDs because it included doctors and engineers, yet they had higher mortality than the PhDs. And his speculation was exactly the “Whitehall phenomenon”, that the people with PhDs could decide, “Wow, this is really interesting and I’m not going home tonight, I’m going to stick with this” and then, “Oh God, this experiment isn’t working – I’m going to walk round the lake.” And in his speculation, that’s what control means.

JK: I think it’s fair to say that not everyone agrees entirely with what you call Status Syndrome. Maybe by concentrating on stress you could miss straightforward causes of disease. For example, everyone thought that ulcers were caused by stress, but we now know that they are caused by a bacteria. Is there a danger that by trying to fit everything into this one box, that stress is the underlying cause of disease, we may miss other more subtle causes?

MM: Well, there’s always a danger of being sloppy and unscientific, and just simply lumping everything together under a stress rubric is very dangerous. And it’s very constructive to have people say they disagree with you. But don’t just simply say because we got it wrong with peptic ulcer 30 years ago ergo your data showing that the metabolic syndrome is related to psychosocial processes in the workplace must be wrong is unscientific. To say we now know that ulcers are caused by infection is missing the fact that the h-pylori infection is very common.

JK: H-pylori is the bacteria that is the underlying cause of ulcers, but you’re saying that there could be other reasons as well that bring about …

MM: Of course. Most of us have h-pylori infection but most of us don’t have peptic ulcer. So we know the cause of lung cancer is smoking but we also know that most smokers don’t get lung cancer. So there are other things going on. Now in the case of lung cancer and smoking, all our efforts to reduce smoking have led to this social gradient in smoking. So now it’s a slightly more complex issue: how do we deal with the causes of the cause which leads to the social gradient?

JK: But if you accept that it’s lack of control over our lives that makes us ill, shouldn’t it then be the individual’s responsibility to take control of their lives?

MM: Of course. But we’re not all equally given the conditions that allow us to take control of our lives. If you’re leaving school with five ‘Cs’ or less at GCSE, and there’s an economic downturn and just under one million 18-24-year-olds are unemployed, how can you take control of your life? It’s not your fault there are no jobs around. So yes, finally, ultimately, I would like everybody to be in the position where they can take control over their lives. But we’ve got to get the conditions right.

JK: There will people who will say you’re talking about the nanny state, an interventionist state that tries to…people can’t empower themselves…

MM: If you think it’s the nanny state to provide a good education system, well go ahead. I wouldn’t say that’s the nanny state. I would say that we’re failing children on a grand scale – we’re not giving them the resources to be able to take control over their lives! That’s anything but the nanny state! That’s what I would want any state to deliver – a decent education system. Now we know the performance in GCSEs isn’t just due to what goes on in schools. The quality of early childhood development is key. If you want to reduce inequalities in early childhood development, you’ve got to reduce inequalities in society. I don’t think that’s the nanny state. If the nanny state said you can’t play rugby because you might get injured – that is the nanny state.    

JK: Clearly a lot of different issues and factors have to be considered together here, but how do you go from scientific evidence to policy and what motivates you to do so?

MM: I started doing this because I was really interested in the scientific question. Then one thing led to another – we published hundreds of scientific papers, richly rewarding, very exciting, feeling you’re making progress. But underneath it all is the question, what if somebody took this seriously? Couldn’t we do something about this to improve people’s lives? If you reach the judgement that we could make that social gradient shallower and we don’t do that, isn’t that rather unjust? Am I being hopelessly na├»ve?   

JK: It sounds like (and it’s been quoted that this is what you do), you’re mixing ideology with evidence. 

MM: The WHO Commission on the social determinants of health had been criticised as being ideology with evidence. I took that criticism as praise – I said we do have an ideology: health inequalities that are judged to be avoidable by reasonable means and are not avoided are wrong, they’re unjust, they’re unfair. And so our ideology is to do something about that. But the evidence really matters.

JK: You see now, it sounds admirable, and it’s certainly true that scientists should be more ethically aware of their moral responsibility of the research that they do across the whole of science. But there is the danger, certainly if you had ideology driving the scientific evidence, that somehow the science becomes less objective, however good and admirable and good those motives are.

MM: Yes, and I think that’s a real danger. But there’s also a danger in saying I’m a pure scientist and I don’t care if anybody takes this seriously or not. The area in which I’ve been labouring, which is really about public health, is about improving things. But we want the best evidence. I’ve tried to make my prejudice clear, my ideology I call it, not a prejudice.

JK: And now you’ve essentially entered the global stage with reports for the World Health Organisation, the European Union, looking at social determinants of health internationally. Do other counties show the same trends as you’ve found in the UK?

MM: What’s absolutely remarkable is that wherever we look we find a social gradient in health.

(A podcast of the entire interview is available on the BBC Radio 4 website under the programme title “The Life Scientific”.)

A very clever piece of brief education about pain

Fascinating thoughts on the next technological wave by David Butler

Health workers can save the planet!!
Most of the public consider that health costs are a necessary financial drag on society and few health workers pause to consider their job as an economic driver or an invention which may be critical to the continuation of a way of life. Health as an economic driver in the format of labour markets, insurance and building new hospitals is quite obvious (imagine the unemployment if there were no health care jobs), but something deeper beckons if health workers are to be saviours of the on if you wish – it's time for a slightly heavy noinotes!!

Waves of economic activity – meet Nikolai Kondratieff
It is quite obvious in society, especially capitalist societies, that economic activity and prosperity often go in waves – the 10-12 year waves are most obvious, though many people in Europe and America are looking anxiously for the next wave! Other waves of economic activity have been described. Nikolai Kondratieff (Russian of course) proposed 60 year cycles of economic activity focussing on a particular invention which has led to enhanced productivity. Note the six waves of inventions in figure 1. Note also that the invention which underpins the current 6th Kondratieff wave is suggested as health and in particular biotechnologies and psychosocial health. The 5th Kondratieff was information technology. While the impact of IT is still strong, it is dwindling, at least in the West, where most people have access to a computer. Although, various estimates suggest that only 10% of the world population have access to a computer.

Image adapted from

Health as economic driver?
Health as invention or economic driver may seem a bit odd. It is not really tangible like railways and steel which underpinned the 2nd Kondratieff wave. A good example of advances in biotechnologies includes the recent major steps towards a vaccine for malaria but it is the psychosocial health (perhaps it should be rephrased as biopsychosocial health) which is of interest here. Psychosocial health in regard to the 6th Kondratieff involves "attempts to better understand and tap into humans' internal information processes, and the wide field of mental and social potentials" with the suggestion that future successful economies and companies will rely on the health of their people and the health of the public health system as a whole – spiritually, bodily, socially, ecologically and mentally. [1] Wow! All this suggests, supports and encourages a powerful information medicine.

You have to think a bit laterally here to grasp it. Those of us who were not born with computers had to think in a different more systematic way to manage computers, but we seemed to manage. It will require quite a shift (eg resources to appropriate education, fair distribution of societal wealth) to access the untouched reserve of human mental potential to restructure a health care system into one where repairing disease continues but the focus is on health. This "information medicine" must be powerful.

The 6th Kondratieff, information medicine and the power of biology
We believe that the information medicine underpinning the 6th Kondratieff will emerge mainly from neurobiology and in particular recent neuroimmune science. For example, here is a pathway of knowledge that has only been available in the last decade... We know that altered use and pain experienced in a body part will lead to changes in the representation of that part in the brain. We know that this is a neuroimmune event most likely related to the activation of groups of glial cells which are essentially immune organs. We know that the immune system is, as Mick Thacker states, is "a system which can identify self from non self", i.e. it is a system that "knows who you are and will respond when you are not you". Responses could be fighting infection or altering the way the body is in the brain. However "you are not you" is not only a state which exists with a disease or injury, it also exists when you are socially dislocated, feel meaningless, have pain that you don't understand or don't have the means (cognitive, knowledge, finances etc) to even begin self-management of a problem. You "may not be you" if you are in a society yet to deal with ageism, racism, sexism and every other "ism". There must be neuroimmune effects leading to pain, disease and altered cognitions and emotions, all of which we now know that the immune system has a hand in [2].

Isn't it a bit too capitalist? 
My dear friend Mick Thacker, responsible for much of the neuroimmune mutterings above (and who now owns a stuffed badger) suggested a danger with the "health invention" falling into the hands of the capitalists, and he may be right. Growth theories don't appeal to everyone and well-being is not necessarily related to economic productivity and dollars. Nikolai Kondratieff certainly fell out with the Trotskyites in Moscow and he ended his days cooling his heels in a Siberian labour camp. But notions of linking a person's existing mental and spiritual powers to information medicine have great links to the health literacy movement, and you would hope that an awakening of these powers would limit misuse.

Some recent projects in Scotland have links to the 6th Kondratieff. (Scottish politics are usually left of the English) Here, the Chief Medical Officer [3] has launched an Assets Alliance for Scotland – health assets being any factor or resource which maintains the ability to sustain and maintain health and well-being. One of the greatest health assets is the still untapped productivity that we all have as part of our mental/spiritual/psychological makeup. Knowledge is the key to unlocking it and thus there are enormous links to the information medicine underpinning the 6th Kondratieff. 

Will you come on the trip?
One way to contribute to and benefit from the 6th Kondratieff is to reduce our own knowledge gaps as biopsychosocial knowledge races away from standard practice. So I am pushing the NOI conference here, a proactive conference on neuroimmune backed biopsychosocialism which pushes health as an economic driver. Check out the list of remarkable plenary and invited speakers – perhaps the best ever list of speakers at an Australian Rehabilitation conference and the massive "what to do about it" list of workshops and lunchtime events. There is a deep underlying theme here of informed self-management, professional and personal empowerment, information medicine and the critical neurobiology, in particular the engagement of the brain, which we see a vital to health as a successful 6th Kondratieff.


Nefiodow, L.A.; Available from: 
Fields, R.D., The Other Brain. 2009, New York: Simon and Schuster.
Burns, H.; Available from:

Monday, 17 October 2011

RSA Animate - The Secret Powers of Time

Interesting take on overpopulation

Psychosis isn't always pathological - BPS Research Digest 198, 6.10.11

Unusual, psychotic-like symptoms, such as hearing voices, are not as rare among the general population as you might think. For example, it's estimated that ten per cent of us hear voices that aren't there, with only a small minority likely to ever receive a clinical diagnosis. According to a new study, this means that the factors that cause psychotic-like symptoms are likely different from those that lead to a diagnosis of pathological psychosis. Charles Heriot-Maitland and his colleagues argue that this distinction has been missed by the majority of past studies that hunted the causes of psychosis by focusing only on patients, neglecting those who live happily with their psychotic-like experiences.

To make a start rectifying this situation, Heriot-Maitland's team interviewed six patients with psychosis (recruited via psychosis teams in SE England) and six "healthy" non-patients, who reported similar unusual experiences (recruited via UK networks involved with spiritual or psychic phenomena). Across both groups, these experiences included: receiving visions from God, hearing voices, and feeling that their body had been taken over. Based on their symptoms alone, you couldn't tell which group a participant belonged to - clinical or non-clinical. The researchers asked all the participants open-ended questions about the circumstances that led to the onset of their unusual experiences, how they felt about them and how their friends, relatives and other people had responded.

Using a qualitative method called Interpretative Phenomenological Analysis, the researchers looked for emerging themes in the participants' answers. Both similarities and differences emerged. In both groups, their unusual psychotic experiences had started after a period of negative emotion, most often accompanied by feelings of isolation and deep contemplation about the meaning of life. However, the groups differed in how they responded to and perceived their odd experiences. Members of the non-clinical group had been more aware of non-medical interpretations of their symptoms; they viewed them as transient and desirable; and people close to them shared this non-pathologising perspective. By contrast, the patients encountered invalidating, medical interpretations of their experiences and were themselves less able to accept their experiences and to incorporate them into their personal and social worlds.

From a theoretical point of view, Heriot-Maitland and his colleagues said there was a need for a more precise approach to the study of psychosis, which distinguishes risk factors for psychotic experiences from risk factors for actual clinical vulnerability. "It would seem that the more out-of-the-ordinary experiences are associated with clinical psychosis, the less chance people have of recognising their desirability, transiency, and psychological benefits, and the more chance they have of detrimental clinical consequences."

The researchers added that this has important clinical implications: "psychotic experiences should be normalised," they said, "and people with psychosis should be helped to re-connect the meaning of their out-of-the-ordinary experiences with the genuine emotional and existential concerns that preceded them." They also acknowledged that more studies, including quantitative investigations, are needed to build on this initial work.

Heriot-Maitland, C., Knight, M., and Peters, E. (2011). A qualitative comparison of psychotic-like phenomena in clinical and non-clinical populations. British Journal of Clinical Psychology DOI:

Tuesday, 13 September 2011

Harold Laski The Dangers of Obedience

“Civilisation means, above all, an unwillingness to inflict unnecessary pain. Within the ambit of that definition, those of us who heedlessly accept the commands of authority cannot yet claim to be civilized men and women...”

Monday, 12 September 2011

Pre-Bed Booze May Bust Rest

A nightcap may force the body to work harder at repair during sleep, making for a less restful night. Katherine Harmon reports
People often turn to wine, beer or cocktails to unwind at the end of the day. These drinks might seem to be relaxing and to aid sleep. But research has shown that people who drink alcohol in the evenings actually get less REM sleep and have less restful nights.

Now a study demonstrates that late-night alcohol might decrease the amount of necessary overnight repair work that the body can do.

Subjects in the study drank strong, weak or alcohol-free beverages an hour-and-40-minutes before going to bed. The more booze the volunteers imbibed, the higher their overnight heart rate. These rapid beats were an indication that their bodies were not in the most productive rest mode, say the researchers. The work appears in the journal Alcoholism: Clinical & Experimental Research. [Yohei Sagawa et al., "Alcohol Has a Dose-Related Effect on Parasympathetic Nerve Activity During Sleep"]

The findings might help explain why those who frequently drink often suffer from insomnia at night and sleepiness during the day, as well as more long-term health effects.

So if you're looking for better, more healthful sleep, maybe avoid the night-time nightcap.

—Katherine Harmon

For those interested, here is the study abstract:

Alcohol Has a Dose-Related Effect on Parasympathetic Nerve Activity During Sleep
  • Yohei Sagawa,
  • Hideaki Kondo,
  • Namiko Matsubuchi,
  • Takaubu Takemura,
  • Hironobu Kanayama,
  • Yoshihiko Kaneko,
  • Takashi Kanbayashi,
  • Yasuo Hishikawa,
  • Tetsuo Shimizu
Article first published online: 16 AUG 2011


  • Alcohol;
  • Ethanol;
  • Sleep;
  • Autonomic Nerve Activity;
  • Heart Rate Variability
Background: The aim of this study was to identify the acute effects of ethanol on the relationship between sleep and heart rate variability (HRV) during sleep.
Methods: Ten healthy male university students were enrolled in this study. An alcoholic beverage was given to each subject at a dosage of 0 (control), 0.5 (low dose: LD), or 1.0 g (high dose: HD) of pure ethanol/kg of body weight. All experiments were performed at 3-week intervals. On the day of the experiment, a Holter electrocardiogram was attached to the subject for a 24-hour period, and the subject was instructed to drink the above-described dosage of alcoholic beverage 100 minutes before going to bed; polysomnography was then performed for 8 hours. Power spectral analysis of the HRV was performed using the maximum entropy method, and the low- (LF: 0.04 to 0.15 Hz) and high-frequency (HF: 0.15 to 0.4 Hz) components along with LF/HF ratio were calculated.
Results: As alcohol consumption increased, the heart rate increased and the spectral power of HRV measured at each frequency range decreased. Higher doses of ethanol also increased the LF/HF ratio compared with the measured ratio of the control group.
Conclusions: Acute ethanol intake inhibits parasympathetic nerve activity and results in predominance of sympathetic nerve activity during sleep, in a dosage-dependent manner. The results of this study suggest that ethanol interferes with the restorative functions of sleep