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.

Permanent Address: http://www.scientificamerican.com/article.cfm?id=closing-gap-between-psychology-and-god

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.
Permanent Address: http://www.scientificamerican.com/article.cfm?id=believing-in-bad-vibes

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, cel2113@columbia.edu, 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 naïve?   

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 planet...read 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 http://kondratieff.net/11.html

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. -Davidwww.noi2012.com

References
Nefiodow, L.A.; Available from: http://kondratieff.net/11.html 
Fields, R.D., The Other Brain. 2009, New York: Simon and Schuster.
Burns, H.; Available from: http://www.scdc.org.uk/assets-alliance-scotland